Individual provider Active NPI

Vivian Fonticiella, PT

  • Physical Therapist
  • Miami, FL
National Provider Identifier
1124210331
Registry record updated Aug 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT21912 Issued in FL
Practice address
200 S Biscayne Blvd
Suite: 15-a
Miami, FL 33131-2310
Phone
(305) 381-6224
Fax
(305) 381-6294
NPI assigned
Aug 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 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 PT21912 FL Primary

Addresses

Primary practice location

200 S Biscayne Blvd
Suite: 15-a
Miami, FL 33131-2310

Mailing address

1172 S Dixie Hwy
#530
Coral Gables, FL 33146-2918
Phone (305) 381-6224

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
Jaguar Therapeutics, LLC Physical Therapist PastSince Dec 23, 2022 Accepting new patients
Downtown Sportfit Rehab and Training Inc Physical Therapist Past Accepting new patients

Organizations & group practices 2

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": "1186790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186790400000",
    "number": "1124210331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1172 S DIXIE HWY",
            "address_2": "#530",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462918",
            "telephone_number": "305-381-6224",
            "fax_number": "305-381-6294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S BISCAYNE BLVD",
            "address_2": "SUITE: 15-A",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331312310",
            "telephone_number": "305-381-6224",
            "fax_number": "305-381-6294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTICIELLA",
        "first_name": "VIVIAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-11",
        "last_updated": "2007-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT21912",
            "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 Aug 11, 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.