Active NPI
Kimberly Ivette Kuilan, SLPA
- Speech-Language Assistant
- Fort Pierce, FL
National Provider Identifier
1649872292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 4206
- Practice address
- 1801 S 23Rd St Ste 2
Fort Pierce, FL 34950-4830 - Phone
- (772) 464-3303
- NPI assigned
- Nov 9, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Assistant | 2355S0801X | 4206 | FL | Primary |
Addresses
Primary practice location
1801 S 23Rd St Ste 2
Fort Pierce, FL 34950-4830
Mailing address
1503 SE Walton Lakes Dr
Port Saint Lucie, FL 34952-5106
Phone (787) 454-1029
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 |
|---|---|---|---|
| 4206 | FL | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604880000000",
"number": "1649872292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1503 SE WALTON LAKES DR",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349525106",
"telephone_number": "787-454-1029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 S 23RD ST STE 2",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "349504830",
"telephone_number": "772-464-3303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUILAN",
"first_name": "KIMBERLY",
"middle_name": "IVETTE",
"credential": "SLPA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-09",
"last_updated": "2020-11-09",
"certification_date": "2020-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "FL",
"license": "4206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Pierce, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.