Individual provider Active NPI

Laura C. Santiago Olivo

  • Speech-Language Pathologist
  • Richmond, TX
National Provider Identifier
1083043590
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA19595 Issued in FL
Practice address
8822 Mugwort Dr
Richmond, TX 77469-2485
Phone
(787) 478-5478
NPI assigned
Nov 5, 2013
Last updated
Mar 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SA19595 FL Primary

Addresses

Primary practice location

8822 Mugwort Dr
Richmond, TX 77469-2485

Mailing address

814 N Main St
Kissimmee, FL 34744-4564
Phone (407) 931-1014

Other practice location 1

814 N Main St
Kissimmee, FL 34744-4564
Phone (407) 931-1014

Other identifiers 1

IdentifierTypeStateIssuer
42011829OtherTXDMV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20251230002467 TX Practitioner - Qualified Speech Language Pathologist 5496241366 Reassigns benefits to 1 organization
I20260302001507 FL Practitioner - Qualified Speech Language Pathologist 5496241366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3419 Westminster Ave
Suite 1062
Dallas, TX 75205-1387

814 N Main St
Kissimmee, FL 34744-4564

8822 Mugwort Dr
Richmond, TX 77469-2485

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SA19595FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kids First Therapy Center Inc. Single Specialty CurrentSince Dec 1, 2025 Accepting new patients
Kids First Therapy Center Inc Single Specialty CurrentSince Jan 18, 2026 Accepting new patients

Locations

814 N Main St
Kissimmee, FL 34744
Phone (407) 930-1000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1083043590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 N MAIN ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347444564",
            "telephone_number": "407-931-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8822 MUGWORT DR",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774692485",
            "telephone_number": "787-478-5478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "814 N Main St",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347444564",
            "country_code": "US",
            "telephone_number": "407-931-1014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTIAGO OLIVO",
        "first_name": "LAURA",
        "middle_name": "C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-05",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA19595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMV",
            "identifier": "42011829",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.