Stefanie Prudente, BS

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

License

5484 Issued in FL

Practice address

206 Ridgewood Ave
Brandon, FL 33510-4617

Phone

(813) 662-1060

NPI assigned

Jun 14, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

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.

• Pediatric Therapy Services Inc

  • Clinic/Center
  • Lakeland, FL
  • NPI 1407834021
  NPD (past)
• Pediatric Therapy Services, Inc.

  • Clinic/Center
  • Brandon, FL
  • NPI 1871769349
  NPD (past)

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1306576129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2818 MILLBROOK RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035274",
            "telephone_number": "570-687-1278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 RIDGEWOOD AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335104617",
            "telephone_number": "813-662-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUDENTE",
        "first_name": "STEFANIE",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "5484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Proficient Integration Mental Health LLC.
• Progressive Behavior Management Res, Inc.
• Progressive Thearpy Services
• Promed Healthcare Services, LLC
• Prostate Cancer Institute of Florida PA
• Psychiatric Care Center LLC
• Publix Super Markets Inc
• Publix Super Markets Inc
• Publix Super Markets Inc
• Publix Super Markets, Inc.

• All providers in Brandon, FL
• Speech-Language Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.