Individual provider Active NPI

Angela Katherine Ocampo Lara, P.T.

  • Physical Therapist
  • Fort Lauderdale, FL
National Provider Identifier
1033439567
Registry record updated Jun 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
032678 Issued in NY
Practice address
3201 W Commercial Blvd Ste 116
Fort Lauderdale, FL 33309-3444
Phone
(954) 739-4247
NPI assigned
Jun 7, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 004574 IA
Physical Therapist 225100000X 032678 NY Primary

Addresses

Primary practice location

3201 W Commercial Blvd Ste 116
Fort Lauderdale, FL 33309-3444

Mailing address

16749 SW 16TH St
Pembroke Pines, FL 33027-1416
Phone (954) 431-4907

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

LicenseStateTypeSpecialty
032678NYMDGeneral Practice Dentistry
004574IAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1275868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275868800000",
    "number": "1033439567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16749 SW 16TH ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271416",
            "telephone_number": "954-431-4907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 W COMMERCIAL BLVD STE 116",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093444",
            "telephone_number": "954-739-4247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARA",
        "first_name": "ANGELA KATHERINE",
        "middle_name": "OCAMPO",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-07",
        "last_updated": "2010-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "004574",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "032678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.

Verify at the official NPI Registry.