Individual provider Active NPI

Amanda Marina Rodriguez

  • Speech-Language Pathologist
  • Tavares, FL
National Provider Identifier
1831071760
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SZ12712 Issued in FL
Practice address
3140 Waterman Way
Tavares, FL 32778-5252
Phone
(352) 253-3809
NPI assigned
Jul 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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 SZ12712 FL Primary

Addresses

Primary practice location

3140 Waterman Way
Tavares, FL 32778-5252

Mailing address

2905 S Palmetto Ave
Sanford, FL 32773-5449
Phone (407) 967-3698

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
SZ12712FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1753142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1831071760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 S PALMETTO AVE",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327735449",
            "telephone_number": "407-967-3698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3140 WATERMAN WAY",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785252",
            "telephone_number": "352-253-3809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "AMANDA",
        "middle_name": "MARINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-22",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ12712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; 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.