Individual provider Active NPI

Diana Samalot, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Port Saint Lucie, FL
National Provider Identifier
1851627772
Registry record updated Oct 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA177 Issued in FL
Practice address
527 NW Cashmere Blvd
Unit 103
Port Saint Lucie, FL 34986-1959
Phone
(772) 204-9822
Fax
(772) 336-9932
NPI assigned
Oct 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2009

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 SA177 FL Primary

Addresses

Primary practice location

527 NW Cashmere Blvd
Unit 103
Port Saint Lucie, FL 34986-1959

Mailing address

766 NW Bayshore Blvd
Port Saint Lucie, FL 34983-1007
Phone (772) 879-0713

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 Science

State licenses

LicenseStateTypeSpecialty
SA177FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256688000000",
    "number": "1851627772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "766 NW BAYSHORE BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349831007",
            "telephone_number": "772-879-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 NW CASHMERE BLVD",
            "address_2": "UNIT 103",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349861959",
            "telephone_number": "772-204-9822",
            "fax_number": "772-336-9932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMALOT",
        "first_name": "DIANA",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-28",
        "last_updated": "2009-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; 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.