Active NPI
Garrett Outland, MA, CCC-SLP
- Speech-Language Pathologist
- Orlando, FL
National Provider Identifier
1104491125
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA20348
- Practice address
- 4705 S Apopka Vineland Rd Ste 100
Orlando, FL 32819-3151 - Phone
- (407) 905-9300
- NPI assigned
- May 21, 2021
- Sex
- Male
- Sole proprietor
- No
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 | SA20348 | FL | Primary |
Addresses
Primary practice location
4705 S Apopka Vineland Rd Ste 100
Orlando, FL 32819-3151
Mailing address
1483 Country Mansion CT
Apopka, FL 32703-5039
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA20348 | FL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Tide Pediatric Therapy LLC | Speech-Language Pathologist | Current | Accepting new patients |
| Magnolia Rehab Services | Speech-Language Pathologist | Past | Accepting new patients |
| Magnolia Rehab Services | Speech-Language Pathologist | Past | Accepting new patients |
Locations
4641 Gulfstarr Dr
Ste 102
Destin, FL 32541
Phone (850) 964-6162
2241 N Monroe St
Tallahassee, FL 32303
Phone (850) 320-8379
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Speech-Language Pathologist
- Crestview, FL
- NPI 1790347896
-
- Speech-Language Pathologist
- Destin, FL
- NPI 1902118540
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779062400000",
"number": "1104491125",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1483 COUNTRY MANSION CT",
"city": "APOPKA",
"state": "FL",
"postal_code": "327035039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4705 S APOPKA VINELAND RD STE 100",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328193151",
"telephone_number": "407-905-9300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OUTLAND",
"first_name": "GARRETT",
"credential": "MA, CCC-SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-21",
"last_updated": "2026-05-18",
"certification_date": "2026-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA20348",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.