Ibck Special Needs Center, Inc.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

IBCK SPECIAL NEEDS CENTER, INC.

Practice address

2275 Fortune Rd
Kissimmee, FL 34744-4404

Phone

(407) 348-2060

Fax

(407) 348-2063

NPI assigned

Oct 14, 2016

Organization subpart

No

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

Authorized official

Name

Benjamin O Gonzalez

Title

Executive Director

Phone

(407) 348-2060

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1476403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476403200000",
    "number": "1265983258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 FORTUNE RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347444404",
            "telephone_number": "407-348-2060",
            "fax_number": "407-348-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 FORTUNE RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347444404",
            "telephone_number": "407-348-2060",
            "fax_number": "407-348-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IBCK SPECIAL NEEDS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-14",
        "last_updated": "2016-10-14",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "407-348-2060"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; 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.