Active NPI
Priscilla Jaime Fotos
- Physical Therapist
- Oviedo, FL
National Provider Identifier
1033680848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT34218
- Practice address
- 1037 Weaver Dr
Oviedo, FL 32765-7028 - Phone
- (407) 319-4619
- NPI assigned
- Dec 6, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | PT34218 | FL | |
| Physical Therapist | 225100000X | PT34218 | FL | Primary |
| Physical Therapist | 225100000X | 299214 | CA |
Addresses
Primary practice location
1037 Weaver Dr
Oviedo, FL 32765-7028
Mailing address
1037 Weaver Dr
Oviedo, FL 32765-7028
Phone (407) 319-4619
Other practice location 1
320 N Crawford St
Willows, CA 95988-2326
Phone (530) 934-2834
Other practice location 2
1501 W Cleveland St Ste 220
Tampa, FL 33606-1812
Phone (813) 805-8105
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT34218 | Other | FL | LICENSE |
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 |
|---|---|---|---|
| 19950 | NC | MD | Pharmacist |
| 299214 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727222400000",
"number": "1033680848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1037 WEAVER DR",
"city": "OVIEDO",
"state": "FL",
"postal_code": "327657028",
"telephone_number": "407-319-4619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1037 WEAVER DR",
"city": "OVIEDO",
"state": "FL",
"postal_code": "327657028",
"telephone_number": "407-319-4619"
}
],
"practiceLocations": [
{
"address_1": "320 N Crawford St",
"address_purpose": "LOCATION",
"city": "Willows",
"state": "CA",
"postal_code": "959882326",
"country_code": "US",
"telephone_number": "530-934-2834",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1501 W Cleveland St Ste 220",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "336061812",
"country_code": "US",
"telephone_number": "813-805-8105",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FOTOS",
"first_name": "PRISCILLA",
"middle_name": "JAIME",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-12-06",
"last_updated": "2024-09-25",
"certification_date": "2024-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "FL",
"license": "PT34218",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT34218",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "299214",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "PT34218",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oviedo, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.