Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shavonne Mariscal

Individual provider Speech-Language Pathologist · NPI 1174161681

Shavonne Mariscal is a Qualified Speech Language Pathologist in Palm Bay, Florida. Qualified in 2010, 16 years ago. Accepts Medicare assignment. Licensed in Florida.

Years since qualifying
16
Licensed in
FL
In the registry since
2019

Practice location Address checks out

4680 Lipscomb St NE Ste 4
Palm Bay, FL 32905-2984
Phone: (321) 209-0171
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence SA11135 (FL)

Record details

NPI number1174161681
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 16, 2019
Last updated in NPPESJuly 7, 2022
Certification dateJuly 7, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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