Eliana Maria Crouzeilles Sobral, SPEECH-LANGUAGE PATH

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA5558 Issued in FL

Practice address

13712 Amelia Pond Dr
Windermere, FL 34786-3114

Phone

(407) 877-5631

Fax

(407) 877-5635

NPI assigned

May 1, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428624000000",
    "number": "1942268925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13712 AMELIA POND DR",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347863114",
            "telephone_number": "407-877-5631",
            "fax_number": "407-877-5635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13712 AMELIA POND DR",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347863114",
            "telephone_number": "407-877-5631",
            "fax_number": "407-877-5635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOBRAL",
        "first_name": "ELIANA MARIA",
        "middle_name": "CROUZEILLES",
        "credential": "SPEECH-LANGUAGE PATH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2015-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA5558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "679537496",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "885537400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Windermere, FL
• Providers in Windermere, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2015; 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.