Individual provider Active NPI

Jose Miguel Vallejo

  • Speech-Language Pathologist
  • Homestead, FL
National Provider Identifier
1154050276
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SI5500 Issued in FL
Practice address
45 NW 8TH St Ste 104
Homestead, FL 33030-4452
Phone
(786) 601-2042
NPI assigned
Jun 6, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 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 Pathologist 235Z00000X SI5500 FL Primary

Addresses

Primary practice location

45 NW 8TH St Ste 104
Homestead, FL 33030-4452

Mailing address

732 Juniper LN
Weston, FL 33327-1838

Other practice location 1

900 W 49th St Ste 322
Hialeah, FL 33012-3407
Phone (786) 953-8256

Other practice location 2

9600 NW 25th St Ph
Doral, FL 33172-1416
Phone (305) 390-1027

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
SI5500FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1154050276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 JUNIPER LN",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333271838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 NW 8TH ST STE 104",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304452",
            "telephone_number": "786-601-2042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 W 49th St Ste 322",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330123407",
            "country_code": "US",
            "telephone_number": "786-953-8256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9600 NW 25th St Ph",
            "address_purpose": "LOCATION",
            "city": "Doral",
            "state": "FL",
            "postal_code": "331721416",
            "country_code": "US",
            "telephone_number": "305-390-1027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALLEJO",
        "first_name": "JOSE",
        "middle_name": "MIGUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-06",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SI5500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homestead, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.