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NPI 1104642628ActiveOrganization· Speech-Language Pathologist· Fort Myers, FL

Speech-Language Pathologist in Fort Myers, Florida, registered in NPPES in November 2024. The authorized official on file is Pavel Manzanares Angulo, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.

Overview

NPI1104642628
StatusActive
Entity typeOrganization
NPI issuedNov 30, 2024
Last updated in NPPESApr 26, 2026
Certified by providerApr 26, 2026

Specialties and licenses

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Part B Supplier - Clinic/Group Practice (FL)

Medicare sources and data years

Other speech-language pathologists in Fort Myers

All 166 speech-language pathologists in Fort Myers · All speech-language pathologists in Florida