Individual provider Active NPI

Mirka Freire, CCC-SLP

  • Speech-Language Pathologist
  • Hialeah, FL
National Provider Identifier
1972639672
Registry record updated Aug 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA8455 Issued in FL
Practice address
18191 NW 68TH Ave
Suite 216
Hialeah, FL 33015-3996
Phone
(305) 558-4646
Fax
(305) 558-4649
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2015

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 SA8455 FL Primary

Addresses

Primary practice location

18191 NW 68TH Ave
Suite 216
Hialeah, FL 33015-3996

Mailing address

9400 SW 31St Ter
Miami, FL 33165-3117
Phone (786) 586-4856

Other identifiers 1

IdentifierTypeStateIssuer
890599100MedicaidFL

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
SA8455FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Estevez S.L.P & Associates, Inc Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439164800000",
    "number": "1972639672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 SW 31ST TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331653117",
            "telephone_number": "786-586-4856",
            "fax_number": "305-558-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18191 NW 68TH AVE",
            "address_2": "SUITE 216",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330153996",
            "telephone_number": "305-558-4646",
            "fax_number": "305-558-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREIRE",
        "first_name": "MIRKA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2015-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA8455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890599100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

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