Individual provider Active NPI

Stacey Gutierrez

  • Speech-Language Assistant
  • Orlando, FL
National Provider Identifier
1144890310
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
4957 Issued in FL
Practice address
5800 Golf Club Pkwy
Orlando, FL 32808-4800
Phone
(407) 904-0134
NPI assigned
Jun 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 4957 FL Primary

Addresses

Primary practice location

5800 Golf Club Pkwy
Orlando, FL 32808-4800

Mailing address

13024 Cordelia LN Unit 207
Orlando, FL 32824-5169
Phone (321) 444-1681

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
4957FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Yakety Yak Speech-Language Pathologists, Inc. Speech-Language Assistant PastSince Aug 1, 2021 Accepting new patients
Milestones Children'S Therapy Center, LLC Speech-Language Assistant PastSince Jul 1, 2021 Accepting new patients
Yakety Yak Speech-Language Pathologists, Inc. PastSince Jul 31, 2022 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1144890310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13024 CORDELIA LN UNIT 207",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328245169",
            "telephone_number": "321-444-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 GOLF CLUB PKWY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328084800",
            "telephone_number": "407-904-0134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUTIERREZ",
        "first_name": "STACEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "4957",
            "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 Jan 28, 2022; 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.