Raveenn Smith Mowbray, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT39558 Issued in FL

Practice address

1000 NE 56TH St
Fort Lauderdale, FL 33334-4149

Phone

(954) 267-6390

NPI assigned

Mar 21, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1023710175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8870 NW 36TH ST APT 3224",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331783541",
            "telephone_number": "912-210-6696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 NE 56TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333344149",
            "telephone_number": "954-267-6390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7800 NW 25th St Ste 4",
            "address_purpose": "LOCATION",
            "city": "Doral",
            "state": "FL",
            "postal_code": "331221623",
            "country_code": "US",
            "telephone_number": "305-593-2174",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH MOWBRAY",
        "first_name": "RAVEENN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT39558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.