Individual provider Active NPI

Vanessa Laurent

  • Speech-Language Pathologist
  • North Fort Myers, FL
National Provider Identifier
1417447004
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA14811 Issued in FL
Practice address
991 Pondella Rd
North Fort Myers, FL 33903-3500
Phone
(239) 995-8809
NPI assigned
May 18, 2018
Last updated
May 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 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 SA14811 FL Primary

Addresses

Primary practice location

991 Pondella Rd
North Fort Myers, FL 33903-3500

Mailing address

3827 17TH St W
Lehigh Acres, FL 33971-5657
Phone (239) 324-7710

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1526601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1417447004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3827 17TH ST W",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339715657",
            "telephone_number": "239-324-7710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "991 PONDELLA RD",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339033500",
            "telephone_number": "239-995-8809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURENT",
        "first_name": "VANESSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-18",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA14811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.