Individual provider Active NPI

Michelle Marie Fernandez, MS., CCC-SLP

  • Speech-Language Pathologist
  • Palmetto Bay, FL
National Provider Identifier
1164906954
Registry record updated Jun 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA20629 Issued in FL
Practice address
8585 SW 148TH Ter
Palmetto Bay, FL 33158-1941
Phone
(786) 973-5441
NPI assigned
Sep 18, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SI3561 FL
Speech-Language Pathologist 235Z00000X SA20629 FL Primary

Addresses

Primary practice location

8585 SW 148TH Ter
Palmetto Bay, FL 33158-1941

Mailing address

8585 SW 148TH Ter
Palmetto Bay, FL 33158-1941
Phone (786) 973-5441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251103000507 FL Practitioner - Qualified Speech Language Pathologist 0244729051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Florida International Univ, College of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4620 N State Rd
Suite 7
Lauderdale Lakes, FL 33319-5884

8585 SW 148TH Ter
Palmetto Bay, FL 33158-1941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SI3561FLMDSpeech-Language Assistant
SA20629FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Michelle Marie Fernandez Speech-Language Pathologist CurrentSince Aug 13, 2025 Accepting new patients

Organizations & group practices 1

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": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719100800000",
    "number": "1164906954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8585 SW 148TH TER",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331581941",
            "telephone_number": "786-973-5441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8585 SW 148TH TER",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331581941",
            "telephone_number": "786-973-5441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "credential": "MS., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2024-06-23",
        "certification_date": "2024-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "SI3561",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA20629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmetto Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.