Active NPI
Marcella Gallego, M.S.
- Speech-Language Pathologist
- Miami, FL
National Provider Identifier
1417183997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA11674
- Practice address
- 12030 SW 123Rd Ter
Miami, FL 33186-5156 - Phone
- (305) 283-5884
- NPI assigned
- Jun 10, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA11674 | FL | Primary |
Addresses
Primary practice location
12030 SW 123Rd Ter
Miami, FL 33186-5156
Mailing address
175 Fontainebleau Blvd
Suite 1-A2
Miami, FL 33172-7018
Phone (305) 283-5884
Other practice location 1
175 Fontainebleau Blvd
Suite 1-A2
Miami, FL 33172-7018
Phone (305) 283-5884
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA11674 | FL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MST Kids LLC | Speech-Language Pathologist | Past | Accepting new patients |
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.
-
- Speech-Language Pathologist
- Miami, FL
- NPI 1326582313
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527033600000",
"number": "1417183997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 FONTAINEBLEAU BLVD",
"address_2": "SUITE 1-A2",
"city": "MIAMI",
"state": "FL",
"postal_code": "331727018",
"telephone_number": "305-283-5884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12030 SW 123RD TER",
"city": "MIAMI",
"state": "FL",
"postal_code": "331865156",
"telephone_number": "305-283-5884"
}
],
"practiceLocations": [
{
"address_1": "175 Fontainebleau Blvd",
"address_2": "Suite 1-A2",
"address_purpose": "LOCATION",
"city": "Miami",
"state": "FL",
"postal_code": "331727018",
"country_code": "US",
"telephone_number": "305-283-5884",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GALLEGO",
"first_name": "MARCELLA",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-10",
"last_updated": "2018-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA11674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.