Active NPI
Monique Ciezczak
- Speech-Language Pathologist
- Orlando, FL
National Provider Identifier
1972133973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA18507
- Practice address
- 12377 S Orange Blossom TRL
Orlando, FL 32837-6215 - Phone
- (407) 857-1212
- Fax
- (407) 857-1239
- NPI assigned
- Jan 19, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA18507 | FL | Primary |
Addresses
Primary practice location
12377 S Orange Blossom TRL
Orlando, FL 32837-6215
Mailing address
3304 Furlong Way
Gotha, FL 34734-5119
Phone (850) 333-9901
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
| License | State | Type | Specialty |
|---|---|---|---|
| SA18507 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677628800000",
"number": "1972133973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3304 FURLONG WAY",
"city": "GOTHA",
"state": "FL",
"postal_code": "347345119",
"telephone_number": "850-333-9901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12377 S ORANGE BLOSSOM TRL",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328376215",
"telephone_number": "407-857-1212",
"fax_number": "407-857-1239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CIEZCZAK",
"first_name": "MONIQUE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-19",
"last_updated": "2023-03-01",
"certification_date": "2023-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA18507",
"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 Mar 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.