Active NPI
Karen Joy Bosilovich, PT, ATC
- Physical Therapist
- Lakeland, FL
National Provider Identifier
1093778987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 29225
- Practice address
- 3900 S Florida Ave
Suite 107
Lakeland, FL 33813-1151 - Phone
- (863) 647-3665
- NPI assigned
- Apr 11, 2006
- Last updated
- Sep 5, 2014
- Sex
- Female
- Sole proprietor
- No
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 Therapist | 225100000X | 29225 | FL | Primary |
Addresses
Primary practice location
3900 S Florida Ave
Suite 107
Lakeland, FL 33813-1151
Mailing address
4040 Eagles Nest Dr
Valrico, FL 33596
Phone (443) 812-0812
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 |
|---|---|---|---|
| 29225 | FL | MD | Physical Therapist |
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409875200000",
"number": "1093778987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4040 EAGLES NEST DR",
"city": "VALRICO",
"state": "FL",
"postal_code": "33596",
"telephone_number": "443-812-0812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 S FLORIDA AVE",
"address_2": "SUITE 107",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338131151",
"telephone_number": "863-647-3665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSILOVICH",
"first_name": "KAREN",
"middle_name": "JOY",
"credential": "PT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-11",
"last_updated": "2014-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "29225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.