Organization Active NPI

Clinica Neurorehabilitar LLC

  • Speech-Language Pathologist
  • Coral Gables, FL
National Provider Identifier
1366149379
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
CLINICA NEUROREHABILITAR LLC
Practice address
2030 S Douglas Rd Ste 109
Coral Gables, FL 33134-4615
Phone
(786) 961-5799
NPI assigned
Feb 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Authorized official

Name
Ana Lucia Collazos
Title
Office Administrator
Phone
(786) 646-7256

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary
Hearing and Speech Clinic/Center 261QH0700X

Addresses

Primary practice location

2030 S Douglas Rd Ste 109
Coral Gables, FL 33134-4615

Mailing address

2030 S Douglas Rd Ste 109
Coral Gables, FL 33134-4615
Phone (786) 961-5799

Other identifiers 1

IdentifierTypeStateIssuer
1124674023MedicaidFL

National Provider Directory

National Provider Directory

Locations

2030 S Douglas Rd
Ste 109
Coral Gables, FL 33134
Phone (786) 961-5799

NPI Registry JSON

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

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675900800000",
    "number": "1366149379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 S DOUGLAS RD STE 109",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331344615",
            "telephone_number": "786-961-5799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 S DOUGLAS RD STE 109",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331344615",
            "telephone_number": "786-961-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA NEUROREHABILITAR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-08",
        "status": "A",
        "authorized_official_last_name": "COLLAZOS",
        "authorized_official_first_name": "ANA LUCIA",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "786-646-7256"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1124674023",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.