Active NPI
Ilona Gofer, M.A. CCC-SLP
- Speech-Language Pathologist
- Orlando, FL
National Provider Identifier
1760715593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA 10215
- Practice address
- 5800 Golf Club Pkwy
Orlando, FL 32808-4800 - Phone
- (407) 299-5553
- NPI assigned
- Sep 11, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA 10215 | FL | Primary |
Addresses
Primary practice location
5800 Golf Club Pkwy
Orlando, FL 32808-4800
Mailing address
2339 River Park Cir
Apt. 1511
Orlando, FL 32817-4884
Phone (772) 579-8404
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001410600 | Medicaid | FL |
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA 10215 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296777600000",
"number": "1760715593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2339 RIVER PARK CIR",
"address_2": "APT. 1511",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328174884",
"telephone_number": "772-579-8404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5800 GOLF CLUB PKWY",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328084800",
"telephone_number": "407-299-5553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOFER",
"first_name": "ILONA",
"credential": "M.A. CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-09-11",
"last_updated": "2011-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA 10215",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001410600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.