Individual provider Active NPI

Maria Cecilia Mauricio, MS, CCC-SLP

  • Speech-Language Pathologist
  • Miami Gardens, FL
National Provider Identifier
1811121882
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 10125 Issued in FL
Practice address
5190 NW 167TH St
Suite 117
Miami Gardens, FL 33014-6328
Phone
(954) 868-3088
Fax
(954) 484-7235
NPI assigned
May 6, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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 SA 10125 FL Primary

Addresses

Primary practice location

5190 NW 167TH St
Suite 117
Miami Gardens, FL 33014-6328

Mailing address

5190 NW 167TH St
Suite 117
Miami Gardens, FL 33014-6328
Phone (954) 868-3088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100317000677 FL Practitioner - Qualified Speech Language Pathologist 1052446952 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA 10125FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Strength and Balance Institute Speech-Language Pathologist CurrentSince Jul 20, 2020 Accepting new patients
Sobe Innovative Rehabilitation PLLC Speech-Language Pathologist CurrentSince Jul 20, 2020 Accepting new patients

Locations

2777 NE 183rd St
Aventura, FL 33160
Phone (305) 405-2014

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": "1241568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1811121882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5190 NW 167TH ST",
            "address_2": "SUITE 117",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330146328",
            "telephone_number": "954-868-3088",
            "fax_number": "954-484-7235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5190 NW 167TH ST",
            "address_2": "SUITE 117",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330146328",
            "telephone_number": "954-868-3088",
            "fax_number": "954-484-7235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURICIO",
        "first_name": "MARIA",
        "middle_name": "CECILIA",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-06",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 10125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.