Jessica Aviva Corcos, M.S, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA13926 Issued in FL

Practice address

1790 SW 43Rd Way
Fort Lauderdale, FL 33317-5701

Phone

(855) 442-2454

Fax

(954) 206-7699

NPI assigned

Jun 28, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1403913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1366857385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 SW 43RD WAY",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333175701",
            "telephone_number": "855-442-2454",
            "fax_number": "954-206-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 SW 43RD WAY",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333175701",
            "telephone_number": "855-442-2454",
            "fax_number": "954-206-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORCOS",
        "first_name": "JESSICA",
        "middle_name": "AVIVA",
        "credential": "M.S, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-28",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA13926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012443700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coral Ridge Chiroprractic
• Coral Ridge Gastroenterology Associates LLC
• Coral Ridge Pediatrics Inc.
• Coral Ridge Smile
• Michael Andrew Corbin, M.D., L.L.C.
• Melissa Lea Corcos, MS, CCC-SLP
• Maria Cordero
• Regine M. Cordon-Shiver, LCSW
• Yaite Cordova Santiesteban, FNP
• Nathalie Cordova, CNM

• Speech-Language Pathologist in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; 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.