Organization Active NPI

Imagine Pediatric Therapy of Brevard, LLC

  • Speech-Language Pathologist
  • Indialantic, FL
National Provider Identifier
1942857511
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
IMAGINE PEDIATRIC THERAPY OF BREVARD, LLC
Practice address
600 N Sonora Cir
Indialantic, FL 32903-3735
Phone
(321) 223-8791
NPI assigned
Aug 19, 2019
Last updated
Aug 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Authorized official

Name
Yelba Mercedes Delgado, MS. CCC-SLPNPI 1932458403
Title
Speech Language Pathologist
Phone
(321) 223-8791

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X NU Primary

Addresses

Primary practice location

600 N Sonora Cir
Indialantic, FL 32903-3735

Mailing address

600 N Sonora Cir
Indialantic, FL 32903-3735
Phone (321) 223-8791

Other identifiers 2

IdentifierTypeStateIssuer
104044500MedicaidFL
110199500MedicaidFL

Other names 1

  • Imagine Pediatric Therapy, LLC Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754006400000",
    "number": "1942857511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N SONORA CIR",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329033735",
            "telephone_number": "321-223-8791",
            "fax_number": "321-373-8791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N SONORA CIR",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329033735",
            "telephone_number": "321-223-8791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINE PEDIATRIC THERAPY OF BREVARD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-19",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A",
        "authorized_official_last_name": "DELGADO",
        "authorized_official_first_name": "YELBA",
        "authorized_official_middle_name": "MERCEDES",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "321-223-8791",
        "authorized_official_credential": "MS. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104044500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110199500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Imagine Pediatric Therapy, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Indialantic, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; 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.