Individual provider Active NPI

Lourdes Irene Carvajal, S.L.P.

  • Speech-Language Pathologist
  • Miami Lakes, FL
National Provider Identifier
1295967883
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 10702 Issued in FL
Practice address
9164 NW 149TH Ter
Miami Lakes, FL 33018-8058
Phone
(305) 331-6126
Fax
(305) 556-1007
NPI assigned
Aug 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 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 SA 10702 FL Primary

Addresses

Primary practice location

9164 NW 149TH Ter
Miami Lakes, FL 33018-8058

Mailing address

9164 NW 149TH Ter
Miami Lakes, FL 33018-8058
Phone (305) 331-6126

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
SA 10702FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1250208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1295967883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9164 NW 149TH TER",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330188058",
            "telephone_number": "305-331-6126",
            "fax_number": "305-556-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9164 NW 149TH TER",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330188058",
            "telephone_number": "305-331-6126",
            "fax_number": "305-556-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARVAJAL",
        "first_name": "LOURDES",
        "middle_name": "IRENE",
        "name_prefix": "Mrs.",
        "credential": "S.L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-14",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 10702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

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