Active NPI
Carolyn Pallotta, PTA
- Physical Therapy Assistant
- Apopka, FL
National Provider Identifier
1104109933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 22434
- Practice address
- 629 Majestic Oak Dr
Apopka, FL 32712-4083 - Phone
- (407) 884-7120
- NPI assigned
- Sep 28, 2011
- 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 Therapy Assistant | 225200000X | 22434 | FL | Primary |
Addresses
Primary practice location
629 Majestic Oak Dr
Apopka, FL 32712-4083
Mailing address
1200 Lexington Green LN
Sanford, FL 32771-1013
Phone (407) 514-3657
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 |
|---|---|---|---|
| 22434 | FL | MD | Physical Therapy Assistant |
Networks
- Optimum HealthCare HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522281600000",
"number": "1104109933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 LEXINGTON GREEN LN",
"city": "SANFORD",
"state": "FL",
"postal_code": "327711013",
"telephone_number": "407-514-3657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "629 MAJESTIC OAK DR",
"city": "APOPKA",
"state": "FL",
"postal_code": "327124083",
"telephone_number": "407-884-7120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALLOTTA",
"first_name": "CAROLYN",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-28",
"last_updated": "2018-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "22434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Apopka, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.