Individual provider Active NPI

Joshua A Lopez, MASTERS OF SCIENCE

  • Speech-Language Pathologist
  • Port Saint Lucie, FL
National Provider Identifier
1356926091
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SZ9909 Issued in FL
Practice address
1483 SW Bougainvillea Ave
Port Saint Lucie, FL 34953-7302
Phone
(772) 336-6928
NPI assigned
Mar 15, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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 SZ9909 FL Primary

Addresses

Primary practice location

1483 SW Bougainvillea Ave
Port Saint Lucie, FL 34953-7302

Mailing address

5261 NW Torino Lakes Cir
Port Saint Lucie, FL 34986-3238
Phone (305) 302-0487

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
SZ9909FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Speech Therapy Services, Inc. Speech-Language Pathologist CurrentSince Apr 28, 2024 Accepting new patients

Locations

1483 SW Bougainvillea Ave
Port St Lucie, FL 34953
Phone (772) 336-6928

Organizations & group practices 1

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": "1615766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1356926091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5261 NW TORINO LAKES CIR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349863238",
            "telephone_number": "305-302-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1483 SW BOUGAINVILLEA AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349537302",
            "telephone_number": "772-336-6928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "JOSHUA",
        "middle_name": "A",
        "credential": "MASTERS OF SCIENCE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ9909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

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