Active NPI
Pam Davila, MA CCC-SLP
- Speech-Language Pathologist
- Lakeland, FL
National Provider Identifier
1992076251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA8627
- Practice address
- 1010 Carpenters Way
Lakeland, FL 33809-3926 - Phone
- (863) 849-0844
- NPI assigned
- Jan 18, 2012
- Last updated
- Jan 18, 2012
- Sex
- Female
- Sole proprietor
- No
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 | SA8627 | FL | Primary |
Addresses
Primary practice location
1010 Carpenters Way
Lakeland, FL 33809-3926
Mailing address
1010 Carpenters Way
Lakeland, FL 33809-3926
Phone (863) 849-0844
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)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA8627 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326844800000",
"number": "1992076251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 CARPENTERS WAY",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338093926",
"telephone_number": "863-849-0844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 CARPENTERS WAY",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338093926",
"telephone_number": "863-849-0844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVILA",
"first_name": "PAM",
"name_prefix": "Mrs.",
"credential": "MA CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-18",
"last_updated": "2012-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA8627",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.