Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1912480526 Individual Practitioner Female Practitioner

Amanda Lynn Jacob , CCC-SLP

Speech-Language Pathologist • Sunrise, FL

Professional Overview & Biography Verified Profile Summary

Amanda Jacob, CCC-SLP is a registered healthcare professional specializing in Speech-Language Pathologist in Sunrise, FL. Practice services are available at 14201 W SUNRISE BLVD STE 107 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

14201 W Sunrise Blvd Ste 107

Sunrise, FL 333233207

Telephone 9547562818
Fax 9545141126
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Sunrise, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 3.0 Yrs
State Avg: 16.7 Yrs
Regional Practice Density
77 Specialists

Practicing in Sunrise, FL (11640 Statewide)

Telehealth Adoption Rate
0.0% 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: 2020-08-11
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License FL SA17265

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
101048100 (FL)
Commercial Insurance / Payer ID Speech Language Pathologist
SA17265 (FL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

39 Associated Practitioners
Dr. Stacy Downs , DPT

Physical Therapist - Orthopedic

NPI 1013272913

Doctor of Physical Therapy

Michael Torres

Occupational Therapy Assistant

NPI 1023516937
Risa Brand

Speech-Language Pathologist

NPI 1043655871
Faiza Khan , SLP

Speech-Language Pathologist

NPI 1043657224

Speech-Language Pathologist

Samuel Mckay-Corkum

Occupational Therapist

NPI 1083230379
Coreen Ann Cortero

Specialist/Technologist - Speech-Language Assistant

NPI 1134656705

Career & Practice History Timeline

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

10 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 11, 2020

Speech-Language Pathologist (License #SA17265 in FL)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 14, 2019

Speech-Language Pathologist (License #SZ8781 in FL)

👤
Provider Name / Credentials Updated July 22, 2019

Recorded as AMANDA JACOB, CCC-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 22, 2019

Speech-Language Pathologist (License #SA17265 in FL)

NPI Profile Active September 10, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location September 10, 2018

Registered at 14201 W SUNRISE BLVD STE 107, SUNRISE, FL 333233207 (Tel: 9547562818)

📍
Updated Business Mailing Address September 10, 2018

Registered at 14201 W SUNRISE BLVD STE 107, SUNRISE, FL 333233207 (Tel: 9547562818)

👤
Provider Name / Credentials Updated September 10, 2018

Recorded as AMANDA JACOB, SLP-CF

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 10, 2018

Speech-Language Pathologist (License #SZ8781 in FL)

🟢
Initial NPI Registration & Enumeration September 10, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1912480526
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 10, 2018
Last Update: August 11, 2020
Sole Proprietor: Yes

Mailing Address

14201 W Sunrise Blvd Ste 107

Sunrise, FL 333233207

Phone: 9547562818

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.