NPIMap

Individual provider Active NPI

Edward Jacobo Morone, PT

  • Physical Therapist
  • Port St Lucie, FL
National Provider Identifier
1104963602
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT17740 Issued in FL
Practice address
1680 SE Lyngate Dr Ste 203
Port St Lucie, FL 34952-4300
Phone
(772) 773-7055
NPI assigned
Jan 31, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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 PT17740 FL Primary

Addresses

Primary practice location

1680 SE Lyngate Dr Ste 203
Port St Lucie, FL 34952-4300

Mailing address

4971 Le Chalet Blvd Ste 100
Boynton Beach, FL 33436-1418

Other practice location 1

579 NW Lake Whitney Pl Ste 101
Port St Lucie, FL 34986-1622
Phone (772) 245-2275

Other names 1

  • Mr. Eduardo Jacobo Morone Former name

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Illiana Surgery and Medical Center Physical Therapist Past Accepting new patients
Spine Clinics of America SC Past Accepting new patients
Spine Clinics of America Past Accepting new patients

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696291200000",
    "number": "1104963602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4971 LE CHALET BLVD STE 100",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334361418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 SE LYNGATE DR STE 203",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349524300",
            "telephone_number": "772-773-7055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "579 NW Lake Whitney Pl Ste 101",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349861622",
            "country_code": "US",
            "telephone_number": "772-245-2275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORONE",
        "first_name": "EDWARD",
        "middle_name": "JACOBO",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT17740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDUARDO",
            "last_name": "MORONE",
            "middle_name": "JACOBO",
            "prefix": "MR.",
            "credential": "LIC.PT,LIC.ACUP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.

Verify at the official NPI Registry.