Individual provider Active NPI

Abigail Runda

  • Speech-Language Pathologist
  • Oviedo, FL
National Provider Identifier
1780041129
Registry record updated Mar 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA15124 Issued in FL
Practice address
253 Plaza Dr Ste C
Oviedo, FL 32765-6460
Phone
(407) 694-3603
Fax
(321) 296-7130
NPI assigned
Jan 15, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA15124 FL Primary

Addresses

Primary practice location

253 Plaza Dr Ste C
Oviedo, FL 32765-6460

Mailing address

3706 Pickerel CT
Melbourne, FL 32940-1468

Other practice location 1

3706 Pickerel Ct
Melbourne, FL 32940-1468
Phone (321) 704-5257

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

State licenses

LicenseStateTypeSpecialty
SA15124FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Speech Innovations of Central Florida LLC Speech-Language Pathologist Past Accepting new patients
Speech Innovations of Central Florida LLC PastSince Sep 15, 2019 Accepting new patients

Organizations & group practices 2

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": "1452816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1780041129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3706 PICKEREL CT",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329401468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 PLAZA DR STE C",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656460",
            "telephone_number": "407-694-3603",
            "fax_number": "321-296-7130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3706 Pickerel Ct",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329401468",
            "country_code": "US",
            "telephone_number": "321-704-5257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUNDA",
        "first_name": "ABIGAIL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-15",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA15124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2019; 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.