Individual provider Active NPI

Melinda Brooke Tovar, M.A. CCC/SLP

  • Speech-Language Pathologist
  • Lakewood Ranch, FL
National Provider Identifier
1417259573
Registry record updated Nov 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA10000 Issued in FL
Practice address
14415 E State Road 70
Lakewood Ranch, FL 34202-8414
Phone
(941) 758-3140
Fax
(941) 870-4891
NPI assigned
Nov 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2010

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 SA10000 FL Primary

Addresses

Primary practice location

14415 E State Road 70
Lakewood Ranch, FL 34202-8414

Mailing address

14415 E State Road 70
Lakewood Ranch, FL 34202-8414
Phone (941) 758-3140

Other names 1

  • Melinda Brooke Lightsey Former name

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 Arts

State licenses

LicenseStateTypeSpecialty
SA10000FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290470400000",
    "number": "1417259573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14415 E STATE ROAD 70",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342028414",
            "telephone_number": "941-758-3140",
            "fax_number": "941-870-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14415 E STATE ROAD 70",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342028414",
            "telephone_number": "941-758-3140",
            "fax_number": "941-870-4891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOVAR",
        "first_name": "MELINDA",
        "middle_name": "BROOKE",
        "credential": "M.A. CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-23",
        "last_updated": "2010-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA10000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELINDA",
            "last_name": "LIGHTSEY",
            "middle_name": "BROOKE",
            "credential": "M.A CCC/SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lakewood Ranch, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; 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.