Active NPI
Sandra Bermudez
- Speech-Language Assistant
- Lutz, FL
National Provider Identifier
1306284401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SI 2436
- Practice address
- 1402 McCrea Dr
Lutz, FL 33549-3580 - Phone
- (813) 390-9062
- NPI assigned
- Jun 11, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Speech-Language Assistant | 2355S0801X | SI 2436 | FL | Primary |
Addresses
Primary practice location
1402 McCrea Dr
Lutz, FL 33549-3580
Mailing address
1402 McCrea Dr
Lutz, FL 33549-3580
Phone (813) 390-9062
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 |
|---|---|---|---|
| SI 2436 | FL | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472083200000",
"number": "1306284401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1402 MCCREA DR",
"city": "LUTZ",
"state": "FL",
"postal_code": "335493580",
"telephone_number": "813-390-9062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1402 MCCREA DR",
"city": "LUTZ",
"state": "FL",
"postal_code": "335493580",
"telephone_number": "813-390-9062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERMUDEZ",
"first_name": "SANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-11",
"last_updated": "2016-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "FL",
"license": "SI 2436",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lutz, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.