Individual provider Active NPI

Mayra Rivera-Ortiz, SLP

  • Speech-Language Pathologist
  • Fort Myers, FL
National Provider Identifier
1659502532
Registry record updated Feb 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA17083 Issued in FL
Practice address
6657 Kestrel Cir
Fort Myers, FL 33966-1364
Phone
(239) 410-9414
NPI assigned
Jul 27, 2009
Last updated
Feb 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA17083 FL Primary

Addresses

Primary practice location

6657 Kestrel Cir
Fort Myers, FL 33966-1364

Mailing address

6657 Kestrel Cir
Fort Myers, FL 33966-1364
Phone (239) 410-9414

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)
Enrolled
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676073600000",
    "number": "1659502532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6657 KESTREL CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661364",
            "telephone_number": "239-410-9414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6657 KESTREL CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661364",
            "telephone_number": "239-410-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA-ORTIZ",
        "first_name": "MAYRA",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-27",
        "last_updated": "2023-02-11",
        "certification_date": "2023-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA17083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2023; 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.