Active NPI
Nikko Tan Antido, PTA
- Physical Therapy Assistant
- Miami, FL
National Provider Identifier
1083398226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 32769
- Practice address
- 6812 SW 81St St
Miami, FL 33143-7708 - Phone
- (305) 905-4188
- NPI assigned
- Jun 8, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 32769 | FL | Primary |
Addresses
Primary practice location
6812 SW 81St St
Miami, FL 33143-7708
Mailing address
1700 NE 105TH St Apt 306
Miami Shores, FL 33138-2140
Phone (305) 815-1168
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
| License | State | Type | Specialty |
|---|---|---|---|
| 32769 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686182400000",
"number": "1083398226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 NE 105TH ST APT 306",
"city": "MIAMI SHORES",
"state": "FL",
"postal_code": "331382140",
"telephone_number": "305-815-1168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6812 SW 81ST ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331437708",
"telephone_number": "305-905-4188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTIDO",
"first_name": "NIKKO",
"middle_name": "TAN",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-06-08",
"last_updated": "2023-06-08",
"certification_date": "2023-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "32769",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.