Kimberly Denise Goldberg

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SZ6594 Issued in FL

Practice address

1809 E Broadway St
#122
Oviedo, FL 32765-8597

Phone

(407) 359-5693

NPI assigned

Mar 4, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Kimberly Denise Shaw Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Premaplay LLC

  • Occupational Therapist
  • Oviedo, FL
  • NPI 1972922821
  NPD (past)

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

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1457776122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5305 MOUNT VEEDER WAY",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327653424",
            "telephone_number": "954-805-8820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 E BROADWAY ST",
            "address_2": "#122",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327658597",
            "telephone_number": "407-359-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "KIMBERLY",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-04",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ6594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "SHAW",
            "middle_name": "DENISE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Victoria M Glasgow, ST
• Glenn Crider Consulting LLC
• Anika Glick
• Jaslin Ashley Goicoechea, BCABA
• Marcey Miller Gold, LMHC
• Jeffrey R. Golen, M.D.
• Gina Gomez
• Sarah Elizabeth Gonzales-Nguyen
• Diana Alexandra Gonzalez Batero, FNP-BC
• Ashley J Gonzalez Goytia, MD

• Speech-Language Pathologist in Oviedo, FL
• Providers in Oviedo, 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 Mar 4, 2014; 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.