Individual provider Active NPI

Marco Alvarez Perez

  • Physical Therapy Assistant
  • Coral Gables, FL
National Provider Identifier
1124609300
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA30670 Issued in FL
Practice address
1500 S Douglas Rd
Coral Gables, FL 33134-4108
Phone
(305) 448-0146
NPI assigned
Apr 19, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA30670 FL Primary

Addresses

Primary practice location

1500 S Douglas Rd
Coral Gables, FL 33134-4108

Mailing address

25225 SW 109TH Ave
Homestead, FL 33032-6360
Phone (786) 457-5097

Other practice location 1

25225 SW 109th Ave
Homestead, FL 33032-6360
Phone (786) 457-5097

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
PTA30670FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1124609300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25225 SW 109TH AVE",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330326360",
            "telephone_number": "786-457-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S DOUGLAS RD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331344108",
            "telephone_number": "305-448-0146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25225 SW 109th Ave",
            "address_purpose": "LOCATION",
            "city": "Homestead",
            "state": "FL",
            "postal_code": "330326360",
            "country_code": "US",
            "telephone_number": "786-457-5097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALVAREZ PEREZ",
        "first_name": "MARCO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-19",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA30670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; 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.