Individual provider Active NPI

Jacalyn Marie Gomez, M.S. CF-SLP

  • Speech-Language Pathologist
  • Miramar, FL
National Provider Identifier
1912376013
Registry record updated Sep 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SZ 7344 Issued in FL
Practice address
17034 SW 34TH St
Miramar, FL 33027-4539
Phone
(305) 962-4682
NPI assigned
Sep 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2015

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 SZ 7344 FL Primary

Addresses

Primary practice location

17034 SW 34TH St
Miramar, FL 33027-4539

Mailing address

17034 SW 34TH St
Miramar, FL 33027-4539
Phone (305) 962-4682

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
SZ 7344FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Speech Solutions Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1442534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442534400000",
    "number": "1912376013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17034 SW 34TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274539",
            "telephone_number": "305-962-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17034 SW 34TH ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330274539",
            "telephone_number": "305-962-4682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "JACALYN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "M.S. CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-18",
        "last_updated": "2015-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ 7344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2015; 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.