Active NPI
Stephanie Anne Ramos Fangonilo
- Physical Therapist
- Coral Springs, FL
National Provider Identifier
1124591326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA01827500
- Practice address
- 12272 W Sample Rd
Coral Springs, FL 33065-4227 - Phone
- (954) 425-2540
- NPI assigned
- Jan 10, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 40QA01827500 | NJ | Primary |
Addresses
Primary practice location
12272 W Sample Rd
Coral Springs, FL 33065-4227
Mailing address
12272 W Sample Rd
Coral Springs, FL 33065-4227
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 |
|---|---|---|---|
| 40QA01827500 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547078400000",
"number": "1124591326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12272 W SAMPLE RD",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330654227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12272 W SAMPLE RD",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330654227",
"telephone_number": "954-425-2540"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FANGONILO",
"first_name": "STEPHANIE ANNE",
"middle_name": "RAMOS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-10",
"last_updated": "2019-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01827500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coral Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.