Jennifer Moss Mydlarz, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA11744 Issued in FL

Practice address

4205 Bluff Harbor Way
Wellington, FL 33449-8322

Phone

(215) 630-1217

NPI assigned

Jun 22, 2011

Last updated

Oct 4, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Speech Rehab Services LLC

  • Home Health Agency
  • Boca Raton, FL
  • NPI 1114268927
  NPD (past)

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1396031928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BLUFF HARBOR WAY",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334498322",
            "telephone_number": "215-630-1217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 BLUFF HARBOR WAY",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334498322",
            "telephone_number": "215-630-1217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYDLARZ",
        "first_name": "JENNIFER",
        "middle_name": "MOSS",
        "name_prefix": "Ms.",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ 5398",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA11744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ashley Ann Myers, RN, CRNA
• Jermaine A. Myers, MD, MPH
• Oranetta Myers
• Rhonda K. Myrick, ACSW, LCSW
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• Speech-Language Pathologist in Wellington, FL
• Providers in Wellington, 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 Oct 4, 2024; 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.