Individual provider Active NPI

Maybelin Carmona, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Kissimmee, FL
National Provider Identifier
1730599424
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
025422 Issued in NY
Practice address
4476 Lumberdale Rd
Kissimmee, FL 34746-3310
Phone
(646) 736-9096
NPI assigned
May 2, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA17762 FL
Speech-Language Pathologist 235Z00000X SP29967 CA
Speech-Language Pathologist 235Z00000X 025422 NY Primary

Addresses

Primary practice location

4476 Lumberdale Rd
Kissimmee, FL 34746-3310

Mailing address

4476 Lumberdale Rd
Kissimmee, FL 34746-3310
Phone (646) 736-9096

Other practice location 1

3100 47th Ave Unit 2
Long Island City, NY 11101-3068
Phone (718) 593-4121

Other identifiers 1

IdentifierTypeStateIssuer
932368270OtherGHI-EMBLEM HEALTH

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SP29967CAMDSpeech-Language Pathologist
SA17762FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Beyond Speaking Rehab Specialists LLC Speech-Language Pathologist CurrentSince Nov 21, 2021 Accepting new patients

Organizations & group practices 1

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": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1730599424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4476 LUMBERDALE RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347463310",
            "telephone_number": "646-736-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4476 LUMBERDALE RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347463310",
            "telephone_number": "646-736-9096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 47th Ave Unit 2",
            "address_purpose": "LOCATION",
            "city": "Long Island City",
            "state": "NY",
            "postal_code": "111013068",
            "country_code": "US",
            "telephone_number": "718-593-4121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARMONA",
        "first_name": "MAYBELIN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-02",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA17762",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP29967",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "025422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI-EMBLEM HEALTH",
            "identifier": "932368270",
            "state": null
        }
    ],
    "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 Apr 4, 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.