Active NPI
Maittee Grana
- Speech-Language Assistant
- Lakeland, FL
National Provider Identifier
1316526585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SI1235
- Practice address
- 1143 Longwood Oaks Blvd
Lakeland, FL 33811-2343 - Phone
- (813) 486-2696
- NPI assigned
- Apr 5, 2021
- 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 Assistant | 2355S0801X | SI1235 | FL | Primary |
Addresses
Primary practice location
1143 Longwood Oaks Blvd
Lakeland, FL 33811-2343
Mailing address
1143 Longwood Oaks Blvd
Lakeland, FL 33811-2343
Phone (813) 486-2696
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G650540795150 | Other | FL | DL |
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 |
|---|---|---|---|
| SI1235 | FL | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617580800000",
"number": "1316526585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1143 LONGWOOD OAKS BLVD",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338112343",
"telephone_number": "813-486-2696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1143 LONGWOOD OAKS BLVD",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338112343",
"telephone_number": "813-486-2696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANA",
"first_name": "MAITTEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-05",
"last_updated": "2021-04-05",
"certification_date": "2021-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "FL",
"license": "SI1235",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DL",
"identifier": "G650540795150",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.