Individual provider Active NPI

Nayda Ivelisse Davila Fuentes, SLPA

  • Speech-Language Assistant
  • Kissimmee, FL
National Provider Identifier
1194238188
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SI5846 Issued in FL
Practice address
820 Cypress Pkwy Ste B
Kissimmee, FL 34759-3424
Phone
(407) 913-1010
Fax
(407) 992-8697
NPI assigned
Nov 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

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 SI5846 FL Primary

Addresses

Primary practice location

820 Cypress Pkwy Ste B
Kissimmee, FL 34759-3424

Mailing address

PO Box 569
Salinas, PR 00751-0569
Phone (787) 358-0290

Other practice location 1

1000 Emmett St Ste 102
Kissimmee, FL 34741-3605
Phone (407) 913-1010

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
SI5846FLMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy World LLC PastSince May 7, 2024 Accepting new patients
Therapy World LLC PastSince May 7, 2024 Accepting new patients

Organizations & group practices 2

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": "1510531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1194238188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 569",
            "city": "SALINAS",
            "state": "PR",
            "postal_code": "007510569",
            "telephone_number": "787-358-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 CYPRESS PKWY STE B",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347593424",
            "telephone_number": "407-913-1010",
            "fax_number": "407-992-8697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Emmett St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347413605",
            "country_code": "US",
            "telephone_number": "407-913-1010",
            "fax_number": "407-992-8697",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVILA FUENTES",
        "first_name": "NAYDA",
        "middle_name": "IVELISSE",
        "credential": "SLPA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-13",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "SI5846",
            "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 May 3, 2024; 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.