Individual provider Active NPI

Eliza Carrasquillo

  • Speech-Language Assistant
  • Hollywood, FL
National Provider Identifier
1942848676
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SI2583 Issued in FL
Practice address
3335 N University Dr Ste 5
Hollywood, FL 33024-2200
Phone
(954) 442-9422
NPI assigned
Dec 12, 2019
Last updated
Dec 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SI2583 FL Primary

Addresses

Primary practice location

3335 N University Dr Ste 5
Hollywood, FL 33024-2200

Mailing address

3335 N University Dr Ste 5
Hollywood, FL 33024-2200
Phone (954) 442-9422

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

State licenses

LicenseStateTypeSpecialty
SI2583FLMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Specialized Speech Center, Inc. PastSince Dec 15, 2019 Accepting new patients
Specialized Speech Center PastSince Dec 15, 2019 Accepting new patients

Organizations & group practices 2

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": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1942848676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3335 N UNIVERSITY DR STE 5",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330242200",
            "telephone_number": "954-442-9422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3335 N UNIVERSITY DR STE 5",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330242200",
            "telephone_number": "954-442-9422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRASQUILLO",
        "first_name": "ELIZA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-12",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "SI2583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.