David Gancedo, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA28227 Issued in FL

Practice address

2020 NE 163Rd St Ste 207
North Miami Beach, FL 33162-4927

Phone

(305) 949-6461

NPI assigned

Mar 13, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1063971778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3718 NW 12TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331262617",
            "telephone_number": "305-917-5920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 NE 163RD ST STE 207",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331624927",
            "telephone_number": "305-949-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANCEDO",
        "first_name": "DAVID",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "PTA29228",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA28227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liudmila Gagieva
• Gleisy Galarraga
• Ieshy L Gales, LMH
• Johanna Gallego-Eckstein
• Yanisleidys Galvan
• Tatum Garafalo, SLP
• Keren Garber, APRN
• Mirtha Garcia Columbie, NURSE PRACTITIONER
• Manuel A Garcia Herran, MD
• Maria de Los Angeles Garcia Pichardo

• Physical Therapy Assistant in North Miami Beach, FL
• Providers in North Miami Beach, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; 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.