NPIMap

Organization Active NPI

Speech and Occupational Specialists, LLC

  • Clinic/Center
  • Tavares, FL
National Provider Identifier
1326619628
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SPEECH AND OCCUPATIONAL SPECIALISTS, LLC
Practice address
1599 Tropical CT
Tavares, FL 32778-4340
Phone
(407) 399-6556
NPI assigned
Jul 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Authorized official

Name
Jennifer Olesen
Title
Practice Owner
Phone
(407) 399-6556

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1599 Tropical CT
Tavares, FL 32778-4340

Mailing address

1201 Winter Garden Vineland Rd Ste 10
Winter Garden, FL 34787-4380
Phone (407) 399-6556

Other identifiers 1

IdentifierTypeStateIssuer
104945700MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Speech and Occupational Specialists LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625616000000",
    "number": "1326619628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 WINTER GARDEN VINELAND RD STE 10",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347874380",
            "telephone_number": "407-399-6556",
            "fax_number": "407-654-5829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1599 TROPICAL CT",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784340",
            "telephone_number": "407-399-6556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEECH AND OCCUPATIONAL SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A",
        "authorized_official_last_name": "OLESEN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "407-399-6556"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104945700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.

Verify at the official NPI Registry.