Active NPI
Kristen Gonzalez
- Speech-Language Pathologist
- Weston, FL
National Provider Identifier
1639459324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 15695
- Practice address
- 2900 S Commerce Pkwy
Weston, FL 33331-3622 - Phone
- (954) 385-6232
- NPI assigned
- Aug 25, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 14117652 | NY | |
| Speech-Language Pathologist | 235Z00000X | 15695 | FL | Primary |
Addresses
Primary practice location
2900 S Commerce Pkwy
Weston, FL 33331-3622
Mailing address
16352 Segovia Cir N
Fort Lauderdale, FL 33331-4629
Phone (954) 684-3744
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15695 | FL | MD | Massage Therapist |
| 14117652 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Open Lines Speech and Communication PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Rehabilitation Clinic/Center
- New York, NY
- NPI 1417279902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647216000000",
"number": "1639459324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16352 SEGOVIA CIR N",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333314629",
"telephone_number": "954-684-3744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 S COMMERCE PKWY",
"city": "WESTON",
"state": "FL",
"postal_code": "333313622",
"telephone_number": "954-385-6232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "KRISTEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-25",
"last_updated": "2022-03-14",
"certification_date": "2022-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "14117652",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "15695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weston, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.