Individual provider Active NPI

Marcella Gallego, M.S.

  • Speech-Language Pathologist
  • Miami, FL
National Provider Identifier
1417183997
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA11674 Issued in FL
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

Updated by the provider on May 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
SA11674FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.