Individual provider Active NPI

Mario Alberto Landera

  • Speech-Language Pathologist
  • Miami, FL
National Provider Identifier
1942300421
Registry record updated Feb 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SZ4053 Issued in FL
Practice address
1201 NW 16TH St
Audiology Service, Mail Code: 126
Miami, FL 33125-1624
Phone
(305) 575-3148
NPI assigned
Sep 24, 2006
Last updated
Feb 8, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2013

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 SZ4053 FL Primary

Addresses

Primary practice location

1201 NW 16TH St
Audiology Service, Mail Code: 126
Miami, FL 33125-1624

Mailing address

15032 SW 65TH Ter
Miami, FL 33193-2009

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101006000039 FL Practitioner - Qualified Speech Language Pathologist 0345432696 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SZ4053FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Current Accepting new patients
University of Miami CurrentSince Jan 1, 2020 Accepting new patients
University of Miami Speech-Language Pathologist CurrentSince Jan 1, 2020 Accepting new patients
University of Miami Past Accepting new patients
University of Miami Past Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1201 NW 16th St
#126
Miami, FL 33125
Phone (305) 575-3148

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: mlandera2113@direct.med.miami.edu

Organizations & group practices 5

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": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360281600000",
    "number": "1942300421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15032 SW 65TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331932009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 NW 16TH ST",
            "address_2": "AUDIOLOGY SERVICE, MAIL CODE: 126",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331251624",
            "telephone_number": "305-575-3148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDERA",
        "first_name": "MARIO",
        "middle_name": "ALBERTO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-24",
        "last_updated": "2013-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ4053",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 8, 2013; 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.