Individual provider Active NPI

Jorge Felix Guerra Gomez, PTA

  • Physical Therapy Assistant
  • Miami, FL
National Provider Identifier
1124773999
Registry record updated Feb 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
31655 Issued in FL
Practice address
454 NW 22ND Ave Ste 108
Miami, FL 33125-3355
Phone
(305) 890-9691
Fax
(305) 647-6127
NPI assigned
Feb 19, 2022
Last updated
Feb 19, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2022

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 31655 FL Primary

Addresses

Primary practice location

454 NW 22ND Ave Ste 108
Miami, FL 33125-3355

Mailing address

13243 SW 283Rd Ter
Homestead, FL 33033-7374
Phone (786) 442-6686

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
31655FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Viva Therapy Services CurrentSince Feb 27, 2022 Accepting new patients

Locations

454 NW 22nd Ave
Ste 108
Miami, FL 33125
Phone (305) 890-9691

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1645228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645228800000",
    "number": "1124773999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13243 SW 283RD TER",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330337374",
            "telephone_number": "786-442-6686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 NW 22ND AVE STE 108",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331253355",
            "telephone_number": "305-890-9691",
            "fax_number": "305-647-6127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERRA GOMEZ",
        "first_name": "JORGE",
        "middle_name": "FELIX",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-19",
        "last_updated": "2022-02-19",
        "certification_date": "2022-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "31655",
            "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 Feb 19, 2022; 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.