Active NPI
Samuel Lavarias, P.T.,D.P.T.
- Physical Therapist
- Deltona, FL
National Provider Identifier
1023280187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT8641
- Practice address
- 829 Deltona Blvd Ste 204
Deltona, FL 32725-7132 - Phone
- (386) 259-9838
- Fax
- (386) 259-9834
- NPI assigned
- Mar 29, 2008
- Last updated
- Feb 5, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT8641 | FL | Primary |
Addresses
Primary practice location
829 Deltona Blvd Ste 204
Deltona, FL 32725-7132
Mailing address
829 Deltona Blvd Ste 204
Deltona, FL 32725-7132
Phone (386) 259-9838
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT8641 | FL | MD | Physical Therapist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580860800000",
"number": "1023280187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "829 DELTONA BLVD STE 204",
"city": "DELTONA",
"state": "FL",
"postal_code": "327257132",
"telephone_number": "386-259-9838",
"fax_number": "386-259-9834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "829 DELTONA BLVD STE 204",
"city": "DELTONA",
"state": "FL",
"postal_code": "327257132",
"telephone_number": "386-259-9838",
"fax_number": "386-259-9834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAVARIAS",
"first_name": "SAMUEL",
"credential": "P.T.,D.P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-29",
"last_updated": "2020-02-05",
"certification_date": "2020-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT8641",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Deltona, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.