Individual provider Active NPI

Rebeca Fisikelli

  • Speech-Language Pathologist
  • Hollywood, FL
National Provider Identifier
1356620769
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA11016 Issued in FL
Practice address
3335 N University Dr
Suite 5
Hollywood, FL 33024-2200
Phone
(954) 442-9422
NPI assigned
Aug 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

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 SA11016 FL Primary

Addresses

Primary practice location

3335 N University Dr
Suite 5
Hollywood, FL 33024-2200

Mailing address

5230 SW 101St Ter
Cooper City, FL 33328-4950
Phone (305) 342-4044

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
SA11016FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Specialized Speech Center, Inc. Speech-Language Pathologist Past Accepting new patients
Specialized Speech Center Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313452800000",
    "number": "1356620769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5230 SW 101ST TER",
            "city": "COOPER CITY",
            "state": "FL",
            "postal_code": "333284950",
            "telephone_number": "305-342-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3335 N UNIVERSITY DR",
            "address_2": "SUITE 5",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330242200",
            "telephone_number": "954-442-9422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISIKELLI",
        "first_name": "REBECA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-16",
        "last_updated": "2011-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA11016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2011; 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.