Individual provider Active NPI

Andrea Moran Sosa, BCBA

  • Speech-Language Pathologist
  • Kissimmee, FL
National Provider Identifier
1720332364
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SZ11391 Issued in FL
Practice address
1107 Mabbette St
Kissimmee, FL 34741-5161
Phone
(407) 201-8079
NPI assigned
Nov 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-19-39143 FL
Speech-Language AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 2355S0801X 4428 FL
Speech-Language Pathologist 235Z00000X SZ11391 FL Primary

Addresses

Primary practice location

1107 Mabbette St
Kissimmee, FL 34741-5161

Mailing address

7108 S Kanner Hwy
Stuart, FL 34997-7462

Other identifiers 1

IdentifierTypeStateIssuer
119242600MedicaidFL

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4428FLMDPhysical Therapist
SZ11391FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Yakety Yak Speech-Language Pathologists, Inc. Multi-Specialty CurrentSince Aug 6, 2023 Accepting new patients
Yakety Yak Speech-Language Pathologists, Inc. Multi-Specialty PastSince Aug 6, 2023 Accepting new patients

Locations

1107 Mabbette St
Kissimmee, FL 34741
Phone (407) 201-8079

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1352073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1720332364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7108 S KANNER HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349977462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 MABBETTE ST",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415161",
            "telephone_number": "407-201-8079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN SOSA",
        "first_name": "ANDREA",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-05",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-19-39143",
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "4428",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ11391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119242600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.