Eneilitza Ivelisse Reyes Mendoza

Primary specialty

Speech-Language AssistantTaxonomy code 2355S0801X

License

SI-4322 Issued in FL

Practice address

11 Plaza Real South Apt 616
Boca Raton, FL 33432

Phone

(570) 534-8808

NPI assigned

Jun 11, 2022

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

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": "1654905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654905600000",
    "number": "1740910991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 PLAZA REAL SOUTH APT 616",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33432",
            "telephone_number": "570-534-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 PLAZA REAL SOUTH APT 616",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33432",
            "telephone_number": "570-534-8808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES MENDOZA",
        "first_name": "ENEILITZA",
        "middle_name": "IVELISSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-11",
        "last_updated": "2022-06-11",
        "certification_date": "2022-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "SI-4322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Revolution Physical Therapy, LLC
• Jessica Revord, BCBA
• Kelly Lauren Reyer, PHARMD
• Mark Reyer, M.D.
• Edward Gonzalo Reyes Caceres, MA94672
• Lory Reyes, PHD
• Nancy Reyes
• Rita R Reyes, OTR
• Lourdes Reynolds, PT
• Steven Reznick, M.D.

• Speech-Language Assistant in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Speech-Language Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2022; 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.