Edith Lisbeth Jacir, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA5276 Issued in FL

Practice address

2645 Executive Park Dr
Weston, FL 33331-3624

Phone

(954) 644-2645

Fax

(954) 248-1974

NPI assigned

Feb 12, 2007

Last updated

Sep 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Children's Therapy Center & More, Inc.

  • Speech-Language Pathologist
  • Weston, FL
  • NPI 1285878355
  NPD Authorized official
• Children's Therapy Center & More, Inc.

  • Speech-Language Pathologist
  • Weston, FL
  • NPI 1700193679
  NPD Authorized official

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1669514246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4474 WESTON RD STE 214",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333313195",
            "telephone_number": "954-644-2645",
            "fax_number": "954-248-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 EXECUTIVE PARK DR",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313624",
            "telephone_number": "954-644-2645",
            "fax_number": "954-248-1974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACIR",
        "first_name": "EDITH",
        "middle_name": "LISBETH",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA5276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8850445",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jose Irizarry, M.D.
• Danielle Irving
• Isa and Ash Supportive Living LLC
• Liana Isler Kupferman, M.S.
• Dolly Iype, NP
• James Jackson IV
• Jackson Memorial Hospital (University of Miami)
• Melanie Jackson, DPT
• Jeffrey S Jacobs, M.D.
• Marta Rosa Jacobs, PSY D

• Speech-Language Pathologist in Weston, FL
• Providers in Weston, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.