Individual provider Active NPI

Jenifer Marin

  • Speech-Language Pathologist
  • Tampa, FL
National Provider Identifier
1841858628
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
1315 W Fletcher Ave
Tampa, FL 33612-3310
Phone
(813) 269-4879
Fax
(813) 433-5561
NPI assigned
Jun 5, 2019
Last updated
Jun 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X NU Primary
Behavior Analyst 103K00000X NU
Assistant Behavior Analyst 106E00000X NU
Behavior Technician 106S00000X NU

Addresses

Primary practice location

1315 W Fletcher Ave
Tampa, FL 33612-3310

Mailing address

8001 SW 36TH St Ste 9
Davie, FL 33328-1915
Phone (954) 577-7790

Other practice location 1

8001 SW 36th St Ste 9
Davie, FL 33328-1915
Phone (954) 577-7790

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lama Pediatric Therapy Behavior Analyst CurrentSince Jul 2, 2023 Accepting new patients
Lama Pediatric Therapies Behavior Analyst CurrentSince Jul 2, 2023 Accepting new patients

Locations

1315 W Fletcher Ave
Tampa, FL 33612
Phone (813) 269-4879

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1841858628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8001 SW 36TH ST STE 9",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333281915",
            "telephone_number": "954-577-7790",
            "fax_number": "954-577-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 W FLETCHER AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336123310",
            "telephone_number": "813-269-4879",
            "fax_number": "813-433-5561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8001 SW 36th St Ste 9",
            "address_purpose": "LOCATION",
            "city": "Davie",
            "state": "FL",
            "postal_code": "333281915",
            "country_code": "US",
            "telephone_number": "954-577-7790",
            "fax_number": "954-577-7780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARIN",
        "first_name": "JENIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Jun 28, 2023; 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.