Individual provider Active NPI

Mariangely Rampolla Formby, M.S, CCC-SLP

  • Speech-Language Pathologist
  • Sun City Center, FL
National Provider Identifier
1467297192
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA21752 Issued in FL
Practice address
105 Trinity Lakes Dr
Sun City Center, FL 33573-5728
Phone
(813) 634-3324
NPI assigned
Jun 25, 2024
Last updated
Mar 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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 SA21752 FL Primary

Addresses

Primary practice location

105 Trinity Lakes Dr
Sun City Center, FL 33573-5728

Mailing address

16540 Myrtle Sand Dr
Wimauma, FL 33598-4070
Phone (407) 404-3244

Other names 1

  • Mariangely Rampolla Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250414000868 FL Practitioner - Qualified Speech Language Pathologist 9931623741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerme Rehabilitation Florida, LLCGroup PAC ID 3274962790, 151 clinicians

Practice addresses (Care Compare)

3400 SE Aster LN
Empowerme Rehabilitation Stuart
Stuart, FL 34994-5516
Phone (877) 367-9772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Florida, LLC Speech-Language Pathologist CurrentSince Apr 5, 2025 Accepting new patients
Empowerme Rehabilitation Florida, LLC CurrentSince Apr 5, 2025 Accepting new patients

Locations

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1467297192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16540 MYRTLE SAND DR",
            "city": "WIMAUMA",
            "state": "FL",
            "postal_code": "335984070",
            "telephone_number": "407-404-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 TRINITY LAKES DR",
            "city": "SUN CITY CENTER",
            "state": "FL",
            "postal_code": "335735728",
            "telephone_number": "813-634-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMPOLLA FORMBY",
        "first_name": "MARIANGELY",
        "credential": "M.S, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-25",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA21752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIANGELY",
            "last_name": "RAMPOLLA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sun City Center, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.