Active NPI
Danielle Fedorovich, MA, CCC/SLP
- Speech-Language Pathologist
- Clermont, FL
National Provider Identifier
1831337591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA 9808
- Practice address
- 11228 Little Nellie Dr
Clermont, FL 34711-8605 - Phone
- (404) 984-5057
- NPI assigned
- Feb 3, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA 9808 | FL | Primary |
Addresses
Primary practice location
11228 Little Nellie Dr
Clermont, FL 34711-8605
Mailing address
11228 Little Nellie Dr
Clermont, FL 34711-8605
Phone (404) 984-5057
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA 9808 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564444800000",
"number": "1831337591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11228 LITTLE NELLIE DR",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347118605",
"telephone_number": "404-984-5057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11228 LITTLE NELLIE DR",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347118605",
"telephone_number": "404-984-5057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FEDOROVICH",
"first_name": "DANIELLE",
"credential": "MA, CCC/SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-03",
"last_updated": "2019-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA 9808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clermont, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.