Jill Suzanne Lane, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA7798 Issued in FL

Practice address

5451 Davie Road
Davie, FL 33314

Phone

(954) 290-4277

Fax

(954) 584-7816

NPI assigned

Aug 16, 2006

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 2

Other names 1

• Mrs. Jill Suzanne Gomez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1689787624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "995 SW 147 AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33027",
            "telephone_number": "954-290-4277",
            "fax_number": "954-584-7816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5451 DAVIE ROAD",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "33314",
            "telephone_number": "954-290-4277",
            "fax_number": "954-584-7816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "JILL",
        "middle_name": "SUZANNE",
        "name_prefix": "Ms.",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA7798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA",
            "identifier": "12024125",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "888544300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "GOMEZ",
            "middle_name": "SUZANNE",
            "prefix": "MRS.",
            "credential": "MS CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katleen Lamour
• Tanashia Lampkin
• Alexis Landa
• Kasandra Landrian-Ramos, LMFT
• Amanda Marie Landry, LMHC
• Diana None Lange
• Mei Lin Langlongstit
• Michael Anthony Langone, M.D.
• Isabella Lanz
• Laisa Lara Perez

• Speech-Language Pathologist in Davie, FL
• Providers in Davie, 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 Oct 17, 2017; 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.