NPIMap

Organization Active NPI

Orlando Stuttering Center

  • Speech-Language Pathologist
  • Orlando, FL
National Provider Identifier
1114244183
Registry record updated Apr 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 6265 Issued in FL
Legal business name
ORLANDO STUTTERING CENTER
Practice address
4401 E Colonial Dr
Orlando, FL 32803-5200
Phone
(407) 619-7548
Fax
(407) 898-5185
NPI assigned
Apr 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2010

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

Authorized official

Name
Mr. Thomas Gibbons, CCC/SLP
Title
Speech Language Therapist
Phone
(407) 619-7548

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SA 6265 FL Primary

Addresses

Primary practice location

4401 E Colonial Dr
Orlando, FL 32803-5200

Mailing address

4401 E Colonial Dr
Orlando, FL 32803-5200
Phone (407) 619-7548

Other identifiers 1

IdentifierTypeStateIssuer
888245100MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1272499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272499200000",
    "number": "1114244183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 E COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328035200",
            "telephone_number": "407-619-7548",
            "fax_number": "407-898-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 E COLONIAL DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328035200",
            "telephone_number": "407-619-7548",
            "fax_number": "407-898-5185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORLANDO STUTTERING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-29",
        "last_updated": "2010-04-29",
        "status": "A",
        "authorized_official_last_name": "GIBBONS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "SPEECH LANGUAGE THERAPIST",
        "authorized_official_telephone_number": "407-619-7548",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CCC/SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 6265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "888245100",
            "state": "FL"
        }
    ],
    "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 Apr 29, 2010; 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.