Shavonne Mariscal
NPI 1174161681ActiveIndividual· Speech-Language Pathologist· Palm Bay, FL
Speech-Language Pathologist in Palm Bay, Florida, licensed in FL, with an NPI issued in December 2019. Enrolled in Medicare as practitioner - qualified speech language pathologist.
Overview
| NPI | 1174161681 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | Dec 16, 2019 |
| Last updated in NPPES | Jul 7, 2022 |
| Certified by provider | Jul 7, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | SA11135 | FL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Qualified Speech Language Pathologist (FL) |
|---|
Education and affiliations
| Graduation year | 2010 |
|---|---|
| Medicare specialty | Qualified Speech Language Pathologist |
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All 30 speech-language pathologists in Palm Bay · All speech-language pathologists in Florida