Individual provider Active NPI

Maxine Parra

  • Physical Therapist
  • Davie, FL
National Provider Identifier
1063841161
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT27161 Issued in FL
Practice address
11870 W State Road 84 Ste C3
Davie, FL 33325-3811
Phone
(305) 405-0400
NPI assigned
Nov 8, 2013
Last updated
Nov 8, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT27161 FL Primary

Addresses

Primary practice location

11870 W State Road 84 Ste C3
Davie, FL 33325-3811

Mailing address

5387 W 28TH Ave
Hialeah, FL 33016-1915
Phone (305) 405-0400

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
PT27161FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Rehabilitation Center PastSince Jun 23, 2024 Accepting new patients
Club Elite, Corp. Physical Therapist Past Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1063841161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5387 W 28TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330161915",
            "telephone_number": "305-405-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11870 W STATE ROAD 84 STE C3",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333253811",
            "telephone_number": "305-405-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARRA",
        "first_name": "MAXINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-08",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT27161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; 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.