Individual provider Active NPI

Marina De Vivenes Larez, CF-SLP

  • Speech-Language Pathologist
  • Winter Garden, FL
National Provider Identifier
1265312359
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SZ12947 Issued in FL
Practice address
1222 Winter Garden Vineland Rd Ste 112
Winter Garden, FL 34787-4449
Phone
(407) 877-0029
NPI assigned
Sep 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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 SZ12947 FL Primary

Addresses

Primary practice location

1222 Winter Garden Vineland Rd Ste 112
Winter Garden, FL 34787-4449

Mailing address

14139 Lanikai Beach Dr
Orlando, FL 32827-8018

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
SZ12947FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1757289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1265312359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14139 LANIKAI BEACH DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328278018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 WINTER GARDEN VINELAND RD STE 112",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347874449",
            "telephone_number": "407-877-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVENES LAREZ",
        "first_name": "MARINA",
        "middle_name": "DE",
        "credential": "CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-08",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ12947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.