Active NPI
Michelle Denise Matolka, MS, CCC/L-SLP
- Speech-Language Pathologist
- Oviedo, FL
National Provider Identifier
1093950826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA13884
- Practice address
- 1809 E Broadway St # 122
Oviedo, FL 32765-8597 - Phone
- (407) 359-5693
- NPI assigned
- Dec 8, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA13884 | FL | Primary |
Addresses
Primary practice location
1809 E Broadway St # 122
Oviedo, FL 32765-8597
Mailing address
1809 E Broadway St
# 122
Oviedo, FL 32765-8597
Phone (407) 359-5693
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA13884 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1228694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453334400000",
"number": "1093950826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1809 E BROADWAY ST",
"address_2": "# 122",
"city": "OVIEDO",
"state": "FL",
"postal_code": "327658597",
"telephone_number": "407-359-5693",
"fax_number": "407-792-5693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1809 E BROADWAY ST # 122",
"city": "OVIEDO",
"state": "FL",
"postal_code": "327658597",
"telephone_number": "407-359-5693"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATOLKA",
"first_name": "MICHELLE",
"middle_name": "DENISE",
"name_prefix": "Mrs.",
"credential": "MS, CCC/L-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-08",
"last_updated": "2016-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA13884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oviedo, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.