Mary Alexy Moore, SPEECH PATHOLOGY

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA2300 Issued in FL

Practice address

12955 Palms West Dr
Suite 202, Building 8
Loxahatchee, FL 33470-4993

Phone

(561) 753-7010

Fax

(561) 753-7022

NPI assigned

Aug 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740291699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11870 SUELLEN CIR",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146272",
            "telephone_number": "561-798-9537",
            "fax_number": "561-753-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12955 PALMS WEST DR",
            "address_2": "SUITE 202, BUILDING 8",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334704993",
            "telephone_number": "561-753-7010",
            "fax_number": "561-753-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARY",
        "middle_name": "ALEXY",
        "name_prefix": "Ms.",
        "credential": "SPEECH PATHOLOGY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA2300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Loxahatchee, FL
• Providers in Loxahatchee, 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 Jul 8, 2007; 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.