Lourdes Cecilia Corrales, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA 8201 Issued in FL

Practice address

9471 Baymeadows Rd
Suite 304
Jacksonville, FL 32256-7932

Phone

(904) 733-8255

Fax

(904) 733-5034

NPI assigned

Nov 30, 2011

Last updated

Nov 30, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1982971248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11527 WOODGLEN WAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322237453",
            "telephone_number": "904-262-3197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9471 BAYMEADOWS RD",
            "address_2": "SUITE 304",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567932",
            "telephone_number": "904-733-8255",
            "fax_number": "904-733-5034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORRALES",
        "first_name": "LOURDES",
        "middle_name": "CECILIA",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-30",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 8201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOH SPEECH LANGUAGE PATHOLOGIST LICENSE",
            "identifier": "SA 8201",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corporate Health LLC
• John Eugene Corprew, CRPS
• Christina Corpus-Piepenbrink, DO
• Lorenzo Mil Corpus, M.D.
• Michelle Marie Corrado, MD, MBA
• Raphael Augusto Correa Bastianon Santiago, M.D.
• Fernanda Correa Chaves, MD
• Sabrina Correa Da Costa, MD
• Ana Maria Corregidor, MD
• Philip J. Correia, D.D.S.

• Speech-Language Pathologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.