Individual provider Active NPI

Alexis Gavars Burruano, M.A. CCC-SLP

  • Speech-Language Pathologist
  • Orlando, FL
National Provider Identifier
1912723685
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
12116 Shadowbrook LN
Orlando, FL 32828-9210
Phone
(646) 509-5389
NPI assigned
Nov 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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 FL Primary

Addresses

Primary practice location

12116 Shadowbrook LN
Orlando, FL 32828-9210

Mailing address

12116 Shadowbrook LN
Orlando, FL 32828-9210
Phone (646) 509-5389

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 Arts

NPI Registry JSON

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

{
    "created_epoch": "1732665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1912723685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12116 SHADOWBROOK LN",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328289210",
            "telephone_number": "646-509-5389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12116 SHADOWBROOK LN",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328289210",
            "telephone_number": "646-509-5389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURRUANO",
        "first_name": "ALEXIS",
        "middle_name": "GAVARS",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-27",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; 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.