Individual provider Active NPI

Elizabeth De Jesus Terrero Jimenez

  • Speech-Language Assistant
  • Kissimmee, FL
National Provider Identifier
1104656271
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
7450 Issued in FL
Practice address
1200 Pacifica Dr Apt 309
Kissimmee, FL 34744-1154
Phone
(772) 361-5410
NPI assigned
Aug 5, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X FL
Speech-Language Assistant 2355S0801X 7450 FL Primary

Addresses

Primary practice location

1200 Pacifica Dr Apt 309
Kissimmee, FL 34744-1154

Mailing address

1200 Pacifica Dr Apt 309
Kissimmee, FL 34744-1154
Phone (772) 361-5410

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
7450FLMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1722816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753401600000",
    "number": "1104656271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 PACIFICA DR APT 309",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347441154",
            "telephone_number": "772-361-5410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 PACIFICA DR APT 309",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347441154",
            "telephone_number": "772-361-5410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRERO JIMENEZ",
        "first_name": "ELIZABETH",
        "middle_name": "DE JESUS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-05",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "7450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.