Individual provider Active NPI

Denise Chantal Elizondo, M.S.

  • Speech-Language Pathologist
  • Miami, FL
National Provider Identifier
1912169301
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA11015 Issued in FL
Practice address
6190 SW 128TH St
Miami, FL 33156-7133
Phone
(773) 368-0663
Fax
(305) 676-9091
NPI assigned
Jun 27, 2008
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 SA11015 FL Primary

Addresses

Primary practice location

6190 SW 128TH St
Miami, FL 33156-7133

Mailing address

6190 SW 128TH St
Miami, FL 33156-7133
Phone (773) 368-0663

Other identifiers 1

IdentifierTypeStateIssuer
015129000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120522001311 FL Practitioner - Qualified Speech Language Pathologist 7315100708 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Catching Up Therapy, LLC CurrentSince Jun 15, 2023 Accepting new patients
South Florida Rehabilitation Consultants Inc CurrentSince Feb 8, 2012 Accepting new patients
Speech Perfect LLC Speech-Language Pathologist PastSince Jul 24, 2022 Accepting new patients

Locations

11301 S Dixie Hwy
Unit 565841
Miami, FL 33256

7340 SW 48th St
Ste 106
Miami, FL 33155
Phone (305) 501-1513

9055 SW 87th Ave
Ste 312
Miami, FL 33176
Phone (305) 412-9099

Organizations & group practices 3

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": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1912169301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6190 SW 128TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331567133",
            "telephone_number": "773-368-0663",
            "fax_number": "305-676-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6190 SW 128TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331567133",
            "telephone_number": "773-368-0663",
            "fax_number": "305-676-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIZONDO",
        "first_name": "DENISE",
        "middle_name": "CHANTAL",
        "name_prefix": "Ms.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA11015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015129000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.