Individual provider Active NPI

Pamela A. Verdolino, MSPT

  • Physical Therapist
  • West Palm Beach, FL
National Provider Identifier
1104927979
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT16924 Issued in FL
Practice address
5325 Greenwood Ave
Suite 101
West Palm Beach, FL 33407-2452
Phone
(561) 882-6368
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT16924 FL Primary

Addresses

Primary practice location

5325 Greenwood Ave
Suite 101
West Palm Beach, FL 33407-2452

Mailing address

3501 Village Blvd
206
West Palm Beach, FL 33409-7481

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
PT16924FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104927979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 VILLAGE BLVD",
            "address_2": "206",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334097481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 GREENWOOD AVE",
            "address_2": "SUITE 101",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072452",
            "telephone_number": "561-882-6368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDOLINO",
        "first_name": "PAMELA",
        "middle_name": "A.",
        "credential": "MSPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT16924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.