Individual provider Active NPI

Jane Polvinale, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Tampa, FL
National Provider Identifier
1780347815
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA21052 Issued in FL
Practice address
6508 Gunn Hwy
Tampa, FL 33625-4022
Phone
(813) 963-6923
NPI assigned
Oct 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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 SA21052 FL Primary

Addresses

Primary practice location

6508 Gunn Hwy
Tampa, FL 33625-4022

Mailing address

1190 E Washington St Unit 219
Tampa, FL 33602-3712
Phone (630) 765-4854

Other practice location 1

10006 N Dale Mabry Hwy Ste 202
Tampa, FL 33618-4422
Phone (813) 374-0442

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
SZ10229FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Living Inc. CurrentSince Nov 26, 2023 Accepting new patients
Independent Living Inc. Speech-Language Pathologist PastSince Oct 17, 2021 Accepting new patients

Locations

6508 Gunn Hwy
Tampa, FL 33625
Phone (813) 963-6923

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": "1634256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1780347815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 E WASHINGTON ST UNIT 219",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336023712",
            "telephone_number": "630-765-4854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6508 GUNN HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336254022",
            "telephone_number": "813-963-6923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10006 N Dale Mabry Hwy Ste 202",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336184422",
            "country_code": "US",
            "telephone_number": "813-374-0442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLVINALE",
        "first_name": "JANE",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-15",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA21052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; 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.