Lottoya Janiel Manderson

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

030647 Issued in NY

Practice address

3962 SW 188TH Ave
Miramar, FL 33029-2723

Phone

(917) 204-2300

NPI assigned

Aug 4, 2010

Last updated

Aug 4, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

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": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1053625707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3962 SW 188 AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "33029",
            "telephone_number": "917-204-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3962 SW 188TH AVE",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330292723",
            "telephone_number": "917-204-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDERSON",
        "first_name": "LOTTOYA",
        "middle_name": "JANIEL",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-04",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23223",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "030647",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1182928",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pavan Makavana
• Erika Makoukdji, FNP
• Erika Maldonado
• Roberto L Maldonado, M.D.
• Fatima Malik, LMHC
• Christopher A Manios, M.D.
• Barbara W Mankuta, RPH
• Frances Caroll Manns, RBT
• Kwasi Agyeman Manu, M.D.
• Mara Eat LLC

• Physical Therapist in Miramar, FL
• Providers in Miramar, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 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.