Active NPI
Isabella Martinez, SLP
- Speech-Language Pathologist
- Winter Haven, FL
National Provider Identifier
1679165617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA19791
- Practice address
- 7512 Cypress Gardens Blvd
Winter Haven, FL 33884 - Phone
- (321) 337-6243
- NPI assigned
- Feb 10, 2021
- 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 Pathologist | 235Z00000X | SA19791 | FL | Primary |
Addresses
Primary practice location
7512 Cypress Gardens Blvd
Winter Haven, FL 33884
Mailing address
7512 Cypress Gardens Blvd
Winter Haven, FL 33884-3200
Phone (321) 337-6243
Other practice location 1
501 E Main St Ste 4
Haines City, FL 33844-4244
Phone (074) 529-6514
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 109589800 | Medicaid | FL | |
| SA19791 | Other | FL | STATE LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA19791 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701907200000",
"number": "1679165617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7512 CYPRESS GARDENS BLVD",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "338843200",
"telephone_number": "321-337-6243",
"fax_number": "352-717-6829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7512 CYPRESS GARDENS BLVD",
"city": "WINTER HAVEN",
"state": "FL",
"postal_code": "33884",
"telephone_number": "321-337-6243"
}
],
"practiceLocations": [
{
"address_1": "501 E Main St Ste 4",
"address_purpose": "LOCATION",
"city": "Haines City",
"state": "FL",
"postal_code": "338444244",
"country_code": "US",
"telephone_number": "074-529-6514",
"fax_number": "352-717-6829",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTINEZ",
"first_name": "ISABELLA",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-10",
"last_updated": "2023-12-07",
"certification_date": "2023-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA19791",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "109589800",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "SA19791",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winter Haven, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.