Individual provider Active NPI

Corina Jovita Rodriguez Espejo, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Fleming Island, FL
National Provider Identifier
1467059667
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA13944 Issued in FL
Practice address
1851 Golden Eagle Way Ste 43
Fleming Island, FL 32003-4334
Phone
(904) 374-1414
Fax
(877) 736-3470
NPI assigned
Oct 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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 SA13944 FL Primary

Addresses

Primary practice location

1851 Golden Eagle Way Ste 43
Fleming Island, FL 32003-4334

Mailing address

105 Chandler Dr
St Johns, FL 32259-9159

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
SA13944FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1601510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1467059667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CHANDLER DR",
            "city": "ST JOHNS",
            "state": "FL",
            "postal_code": "322599159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 GOLDEN EAGLE WAY STE 43",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034334",
            "telephone_number": "904-374-1414",
            "fax_number": "877-736-3470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPEJO",
        "first_name": "CORINA",
        "middle_name": "JOVITA RODRIGUEZ",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-01",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA13944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleming Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; 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.