Individual provider Active NPI

Veronica Bono, PTA, LMT

  • Physical Therapy Assistant
  • Fort Lauderdale, FL
National Provider Identifier
1053681965
Registry record updated Jan 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA21053 Issued in FL
Practice address
1615 Miami Rd
Fort Lauderdale, FL 33316-2933
Phone
(954) 763-6763
Fax
(954) 763-6760
NPI assigned
Jan 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA21053 FL Primary
Massage Therapist 225700000X MA41431 FL

Addresses

Primary practice location

1615 Miami Rd
Fort Lauderdale, FL 33316-2933

Mailing address

4025 N Federal Hwy Apt 113a
Oakland Park, FL 33308-5501
Phone (954) 640-3568

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

State licenses

LicenseStateTypeSpecialty
PTA21053FLMDPhysical Therapy Assistant
MA41431FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326067200000",
    "number": "1053681965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 N FEDERAL HWY APT 113A",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333085501",
            "telephone_number": "954-640-3568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 MIAMI RD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162933",
            "telephone_number": "954-763-6763",
            "fax_number": "954-763-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONO",
        "first_name": "VERONICA",
        "credential": "PTA, LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-09",
        "last_updated": "2012-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA21053",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA41431",
            "primary": false
        }
    ],
    "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 Jan 9, 2012; 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.