Active NPI
Samantha Charlotin
- Orthopedic Physical Therapist
- Orlando, FL
National Provider Identifier
1164049870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT35614
- Practice address
- 1717 S Orange Ave
Orlando, FL 32806-2944 - Phone
- (407) 515-2420
- Fax
- (407) 447-4452
- NPI assigned
- Jun 29, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT35614 | FL | Primary |
Addresses
Primary practice location
1717 S Orange Ave
Orlando, FL 32806-2944
Mailing address
1717 S Orange Ave
Orlando, FL 32806-2944
Phone (407) 515-2420
Other practice location 1
5535 Cypress Gardens Blvd Ste 260
Winter Haven, FL 33884-2241
Phone (863) 877-0605
Other practice location 2
4525 S Florida Ave Ste 25
Lakeland, FL 33813-2184
Phone (863) 812-4065
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | providerenrollment@orlandohealth.com |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT35614 | FL | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667952000000",
"number": "1164049870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 S ORANGE AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328062944",
"telephone_number": "407-515-2420",
"fax_number": "407-447-4452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 S ORANGE AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328062944",
"telephone_number": "407-515-2420",
"fax_number": "407-447-4452"
}
],
"practiceLocations": [
{
"address_1": "5535 Cypress Gardens Blvd Ste 260",
"address_purpose": "LOCATION",
"city": "Winter Haven",
"state": "FL",
"postal_code": "338842241",
"country_code": "US",
"telephone_number": "863-877-0605",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4525 S Florida Ave Ste 25",
"address_purpose": "LOCATION",
"city": "Lakeland",
"state": "FL",
"postal_code": "338132184",
"country_code": "US",
"telephone_number": "863-812-4065",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHARLOTIN",
"first_name": "SAMANTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-29",
"last_updated": "2022-11-09",
"certification_date": "2022-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "FL",
"license": "PT35614",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "providerenrollment@orlandohealth.com",
"affiliation": "N",
"address_1": "1717 S Orange Ave",
"city": "Orlando",
"state": "FL",
"country_code": "US",
"postal_code": "328062944",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.