Rebecca Klopp Fedor, MEDCCCSLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA3176 Issued in FL

Practice address

13495 Gulf Blvd
Madeira Beach, FL 33708-2515

Phone

(727) 391-4100

Fax

(727) 398-2067

NPI assigned

Jun 14, 2007

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

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 and National Provider Directory roles.

• Robert P. Fedor, D.O.P.a

  • Family Medicine Physician
  • South Pasadena, FL
  • NPI 1073633665
  NPD (past)

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396949087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13495 GULF BLVD",
            "city": "MADEIRA BEACH",
            "state": "FL",
            "postal_code": "337082515",
            "telephone_number": "727-391-4100",
            "fax_number": "727-398-2067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13495 GULF BLVD",
            "city": "MADEIRA BEACH",
            "state": "FL",
            "postal_code": "337082515",
            "telephone_number": "727-391-4100",
            "fax_number": "727-398-2067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDOR",
        "first_name": "REBECCA",
        "middle_name": "KLOPP",
        "name_prefix": "Mrs.",
        "credential": "MEDCCCSLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA3176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "SA3176",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robin Colarusso
• Asia Crawford
• Danielle Dantuma, PHARMD
• Rachel Destefano
• Encompass Healthcare Group, Inc.
• Robert P Fedor, D.O.
• Sharon Gerson, ARNP
• Gulf Coast Surgical Assisting PA
• Emily Handren, LPC
• Aimee Harscher, PHARM. D

• Speech-Language Pathologist in Madeira Beach, FL
• Providers in Madeira Beach, 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 Jul 8, 2007; 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.