Elizabeth Ann Petlev, MSCCCSLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA5629 Issued in FL

Practice address

9291 Glades Rd
Boca Raton, FL 33434-3959

Phone

(561) 955-5437

Fax

(561) 483-7044

NPI assigned

Jun 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215130232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11125 STONE CREEK ST",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334678335",
            "telephone_number": "561-784-1745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9291 GLADES RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334343959",
            "telephone_number": "561-955-5437",
            "fax_number": "561-483-7044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETLEV",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MSCCCSLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA5629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "886163300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "SA5629",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Schulz Peterson, M.O.T., OTR/L
• Shelby Peterson
• Sima Petilli
• Carla Petion
• Luthny Petitdo
• Jaclyn Ann Petrassi, M.A., CCC-SLP
• Raphaella Petrosino, ATC, LAT
• Leanne Petrouske, PHARM D
• Michelle Petru
• Margaret Carthas Petry, PH.D.

• Speech-Language Pathologist in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.