Individual provider Active NPI

Jazzmin A Mestre

  • Speech-Language Assistant
  • Sanford, FL
National Provider Identifier
1225756729
Registry record updated Aug 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SI5728 Issued in FL
Practice address
111 E Lake Mary Blvd Ste 113
Sanford, FL 32773-7111
Phone
(407) 203-9492
Fax
(321) 332-9768
NPI assigned
Aug 19, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 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 AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 2355S0801X SI5728 FL Primary

Addresses

Primary practice location

111 E Lake Mary Blvd Ste 113
Sanford, FL 32773-7111

Mailing address

111 E Lake Mary Blvd Ste 113
Sanford, FL 32773-7111
Phone (407) 694-7838

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
SI5728FLMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Milestones Children'S Therapy Center, LLC Speech-Language Assistant CurrentSince Aug 28, 2022 Accepting new patients

Locations

111 E Lake Mary Blvd
Ste 113
Sanford, FL 32773
Phone (407) 203-9492

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": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1225756729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E LAKE MARY BLVD STE 113",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327737111",
            "telephone_number": "407-694-7838",
            "fax_number": "321-332-9768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E LAKE MARY BLVD STE 113",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327737111",
            "telephone_number": "407-203-9492",
            "fax_number": "321-332-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESTRE",
        "first_name": "JAZZMIN",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "SI5728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.