Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1922148451 Individual Practitioner Female Practitioner

Ivonne Carmen Randolph , MACCCSLP

Speech-Language Pathologist • Port Orange, FL

Professional Overview & Biography Verified Profile Summary

Ivonne Randolph, MACCCSLP is a registered healthcare professional specializing in Speech-Language Pathologist in Port Orange, FL. Practice services are available at 5791 FALLING TREE LN under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

5791 Falling Tree Ln

Port Orange, FL 321277993

Telephone 4075952710

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Port Orange, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 14.5 Yrs
State Avg: 16.7 Yrs
Regional Practice Density
103 Specialists

Practicing in Port Orange, FL (11640 Statewide)

Telehealth Adoption Rate
1.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-02-16
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License FL SA 1206

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Developmental Therapist

NUCC Taxonomy Code: 222Q00000X

A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development.

Early Intervention Provider Agency

NUCC Taxonomy Code: 252Y00000X

Early intervention services are an effective way to address the needs of infants and toddlers who have developmental delays or disabilities. The services are made available through a federal law known as the Individuals with Disabilities Education Act (IDEA). IDEA provides states and territories with specific requirements for providing early intervention services to infants and toddlers with special needs. In turn, each state and territory develops its own policies for carrying out IDEA and its requirements. Broadly speaking, early intervention services are special services for eligible infants and toddlers and their families. These services are designed to identify and meet children's needs in five developmental areas. These areas are: physical development, cognitive development, communication, social or emotional development, and adaptive development.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
884535200 (FL)

Secondary Practice Locations

2219 S Woodland Blvd

Deland, FL 327208628

Phone: 3867369849

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 16, 2025

Developmental Therapist

📍
Updated Practice Location October 15, 2020

Registered at 5791 FALLING TREE LN, PORT ORANGE, FL 321277993 (Tel: 4075952710)

📍
Updated Business Mailing Address October 15, 2020

Registered at 5791 FALLING TREE LN, PORT ORANGE, FL 321277993 (Tel: 4075952710)

NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 09, 2007

Registered at 2219 S WOODLAND BLVD, DELAND, FL 327208628 (Tel: 3867369849)

📍
Updated Business Mailing Address July 09, 2007

Registered at 30135 BLUEBELL AVE W, EUSTIS, FL 32736 (Tel: 3523570316)

👤
Provider Name / Credentials Updated July 09, 2007

Recorded as IVONNE RANDOLPH, MACCCSLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Speech-Language Pathologist (License #SA 1206 in FL)

🟢
Initial NPI Registration & Enumeration February 07, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1922148451
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 07, 2007
Last Update: February 16, 2025
Sole Proprietor: Yes

Mailing Address

5791 Falling Tree Ln

Port Orange, FL 321277993

Phone: 4075952710

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.