Individual provider Active NPI

Debra P Tarakofsky, MS, CCC-SLP

  • Speech-Language Pathologist
  • Sunrise, FL
National Provider Identifier
1275848731
Registry record updated Aug 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA3100 Issued in FL
Practice address
4572 N Hiatus Rd
Sunrise, FL 33351-7987
Phone
(954) 578-4000
Fax
(954) 578-4948
NPI assigned
Aug 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2010

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 SA3100 FL Primary

Addresses

Primary practice location

4572 N Hiatus Rd
Sunrise, FL 33351-7987

Mailing address

11085 NW 15TH St
Coral Springs, FL 33071-6488
Phone (954) 578-4000

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)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Swallowing Diagnostics, Inc. Past Accepting new patients

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": "1281312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281398400000",
    "number": "1275848731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11085 NW 15TH ST",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330716488",
            "telephone_number": "954-578-4000",
            "fax_number": "954-578-4948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4572 N HIATUS RD",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333517987",
            "telephone_number": "954-578-4000",
            "fax_number": "954-578-4948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARAKOFSKY",
        "first_name": "DEBRA",
        "middle_name": "P",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-09",
        "last_updated": "2010-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA3100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; 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.