Individual provider Active NPI

Sara Diluzio Pennell, SLP

  • Speech-Language Pathologist
  • Belle Isle, FL
National Provider Identifier
1811028541
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA8300 Issued in FL
Practice address
1809 Colleen Dr
Belle Isle, FL 32809-6873
Phone
(407) 963-6687
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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 SA8300 FL Primary

Addresses

Primary practice location

1809 Colleen Dr
Belle Isle, FL 32809-6873

Mailing address

1809 Colleen Dr
Belle Isle, FL 32809-6873
Phone (407) 963-6687

Other identifiers 1

IdentifierTypeStateIssuer
889625900MedicaidFL

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
SA8300FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1811028541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 COLLEEN DR",
            "city": "BELLE ISLE",
            "state": "FL",
            "postal_code": "328096873",
            "telephone_number": "407-963-6687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 COLLEEN DR",
            "city": "BELLE ISLE",
            "state": "FL",
            "postal_code": "328096873",
            "telephone_number": "407-963-6687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNELL",
        "first_name": "SARA",
        "middle_name": "DILUZIO",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA8300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "889625900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belle Isle, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.