Individual provider Active NPI

Keegan Melendi Tahiri

  • Speech-Language Pathologist
  • Tampa, FL
National Provider Identifier
1104627348
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SZ12192 Issued in FL
Practice address
4411 N Habana Ave
Tampa, FL 33614-7211
Phone
(813) 872-2771
NPI assigned
Mar 24, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SZ12192 FL Primary

Addresses

Primary practice location

4411 N Habana Ave
Tampa, FL 33614-7211

Mailing address

480 Bosphorous Ave
Tampa, FL 33606-3608
Phone (813) 992-0718

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SZ12192FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1104627348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 BOSPHOROUS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336063608",
            "telephone_number": "813-992-0718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4411 N HABANA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147211",
            "telephone_number": "813-872-2771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAHIRI",
        "first_name": "KEEGAN",
        "middle_name": "MELENDI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-24",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ12192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.