Organization Active NPI

Decir Pediatric Specialty

  • Speech-Language Pathologist
  • Orlando, FL
National Provider Identifier
1770015455
Registry record updated Mar 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
13501 Issued in FL
Legal business name
DECIR PEDIATRIC SPECIALTY
Practice address
1820 Nestlewood TRL
Orlando, FL 32837-8011
Phone
(954) 529-7194
NPI assigned
Mar 31, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2017

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

Authorized official

Name
Ms. Consuelo Monica De Avila, M.S., CCC-SLP
Title
Speech-Language Pathologist
Phone
(954) 529-7194

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 13501 FL Primary

Addresses

Primary practice location

1820 Nestlewood TRL
Orlando, FL 32837-8011

Mailing address

1820 Nestlewood TRL
Orlando, FL 32837-8011
Phone (954) 529-7194

Other identifiers 1

IdentifierTypeStateIssuer
016613600MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1490918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490918400000",
    "number": "1770015455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 NESTLEWOOD TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328378011",
            "telephone_number": "954-529-7194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 NESTLEWOOD TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328378011",
            "telephone_number": "954-529-7194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECIR PEDIATRIC SPECIALTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-31",
        "last_updated": "2017-03-31",
        "status": "A",
        "authorized_official_last_name": "DE AVILA",
        "authorized_official_first_name": "CONSUELO",
        "authorized_official_middle_name": "MONICA",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "954-529-7194",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "13501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016613600",
            "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 Mar 31, 2017; 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.