NPIMap

Organization Active NPI

Eastside Speech and Pathology

  • Speech-Language Pathologist
  • Oakland Park, FL
National Provider Identifier
1598891483
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2007001985 Issued in FL
Legal business name
EASTSIDE SPEECH AND PATHOLOGY
Practice address
840 E Oakland Park Blvd
Suite 115
Oakland Park, FL 33334-2767
Phone
(954) 565-4437
Fax
(954) 565-4476
NPI assigned
Feb 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Lynnette L Granger, M.S. CCC-SLPNPI 1720110646
Title
President
Phone
(954) 565-4437

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 2007001985 FL Primary

Addresses

Primary practice location

840 E Oakland Park Blvd
Suite 115
Oakland Park, FL 33334-2767

Mailing address

840 E Oakland Park Blvd
Suite 115
Oakland Park, FL 33334-2767
Phone (954) 565-4437

Other names 1

  • Eastsides Speech and Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

840 E Oakland Park Blvd
Ste 115
Oakland Park, FL 33334
Phone (954) 565-4437

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598891483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 E OAKLAND PARK BLVD",
            "address_2": "SUITE 115",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333342767",
            "telephone_number": "954-565-4437",
            "fax_number": "954-565-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 E OAKLAND PARK BLVD",
            "address_2": "SUITE 115",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333342767",
            "telephone_number": "954-565-4437",
            "fax_number": "954-565-4476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE SPEECH AND PATHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRANGER",
        "authorized_official_first_name": "LYNNETTE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-565-4437",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "2007001985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastsides Speech and Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.