Active NPI
Manuel M Penton, ATC
- Athletic Trainer
- Miami, FL
National Provider Identifier
1033424692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 4200 SW 89TH Ave
Miami, FL 33165-5336 - Phone
- (305) 226-8152
- NPI assigned
- Aug 6, 2010
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
4200 SW 89TH Ave
Miami, FL 33165-5336
Mailing address
11815 SW 51St St
Miami, FL 33175-5609
Phone (305) 479-4328
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281052800000",
"number": "1033424692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11815 SW 51ST ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331755609",
"telephone_number": "305-479-4328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4200 SW 89TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331655336",
"telephone_number": "305-226-8152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENTON",
"first_name": "MANUEL",
"middle_name": "M",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-08-06",
"last_updated": "2010-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.