Active NPI
Nila Illuzzi
- Speech-Language Pathologist
- Fort Pierce, FL
National Provider Identifier
1275396012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SZ11843
- Practice address
- 5050 S 25TH St
Fort Pierce, FL 34981-4923 - Phone
- (772) 216-3634
- NPI assigned
- Feb 5, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SZ11843 | FL | Primary |
Addresses
Primary practice location
5050 S 25TH St
Fort Pierce, FL 34981-4923
Mailing address
1621 SW Realty St
Port St Lucie, FL 34987-2227
Phone (772) 607-4834
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
| License | State | Type | Specialty |
|---|---|---|---|
| SZ11843 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707091200000",
"number": "1275396012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1621 SW REALTY ST",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349872227",
"telephone_number": "772-607-4834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5050 S 25TH ST",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349814923",
"telephone_number": "772-216-3634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ILLUZZI",
"first_name": "NILA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-05",
"last_updated": "2024-02-05",
"certification_date": "2024-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SZ11843",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Pierce, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.