Patrick Dennis Lavallie

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA1438 Issued in FL

Practice address

1010 US 27 N
Avon Park, FL 33825-2556

Phone

(863) 453-5200

NPI assigned

Feb 5, 2019

Last updated

Feb 5, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1549324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549324800000",
    "number": "1568927481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 TRAFALGAR WAY",
            "city": "LAKE PLACID",
            "state": "FL",
            "postal_code": "338527906",
            "telephone_number": "954-675-8842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 US 27 N",
            "city": "AVON PARK",
            "state": "FL",
            "postal_code": "338252556",
            "telephone_number": "863-453-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVALLIE",
        "first_name": "PATRICK",
        "middle_name": "DENNIS",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-05",
        "last_updated": "2019-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA1438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Rose Knickerbocker, D.O.
• J. Agustin Lacson, M.D.
• Arleen Ann Lally, D.O.
• Long Lam, PHARMD
• Ashlynne Feely Langford, APRN, CPNP-PC
• Carla Ledane, MA
• Amisadai Leon, RBT
• Sherri Lewis-Bikar
• Hannah Joy Loomis
• Wilfredo Lopez-Reyes, M.D.

• Speech-Language Pathologist in Avon Park, FL
• Providers in Avon Park, 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 Feb 5, 2019; 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.