Adrienne Peters CCC PA

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA 1190 Issued in FL

Legal business name

ADRIENNE PETERS CCC PA

Practice address

2645 SW 37TH Ave
Suite 304
Miami, FL 33133

Phone

(305) 448-7101

Fax

(305) 442-8730

NPI assigned

Nov 29, 2006

Last updated

May 1, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Maryanne A Goldberg

Title

Office Manager

Phone

(305) 448-7101

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1659448272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 SW 37TH AVE",
            "address_2": "SUITE 304",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33133",
            "telephone_number": "305-448-7101",
            "fax_number": "305-442-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 SW 37TH AVE",
            "address_2": "SUITE 304",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33133",
            "telephone_number": "305-448-7101",
            "fax_number": "305-442-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADRIENNE PETERS CCC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "MARYANNE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "305-448-7101"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 1190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "887325900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.