Lisa Ceballo
Individual provider Active NPI Speech-Language Pathologist · Palmetto, FL
NPI 1891247516 · NPPES record last updated Sep 16, 2024
Key facts
- NPI
- 1891247516
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- Practice address
- 3406 70TH CT E
Palmetto, FL 34221-7381 - Phone
- (631) 766-7623
- NPI assigned
- Oct 28, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2016
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
425 2ND St
Suite 405
San Francisco, CA 94107-1400
489 Sanchez St
San Francisco, CA 94114-2056
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250916003978 | FL | Practitioner - Qualified Speech Language Pathologist | 3971007667 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hona Medical Group PA | Speech-Language Pathologist | Current |
Accepting new patients |
| Salt and Light Speech Therapy, LLC | Current |
Accepting new patients |
Locations
903 25th Dr E
Ste C
Ellenton, FL 34222
6303 Waterford District Dr
Ste 400
Miami, FL 33126
Phone (786) 801-1571
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Yes |
Addresses
Primary practice location
3406 70TH CT E
Palmetto, FL 34221-7381
Mailing address
3406 70TH CT E
Palmetto, FL 34221-7381
Phone (631) 766-7623
Other providers in Palmetto, FL
- Elizabeth Carpenter
- Nicki Marie Casado
- Valentino Castro
- Sharon Causin
- Christin M Caviness
- Zeina Chakar
- Amy Nicole Charles
- Children'S Therapy Solutions Inc.
- Jessica Cicero
- Miriam Cisnero Perez
All providers in Palmetto, FL · Speech-Language Pathologist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.