Individual provider Active NPI

Lourdes M Palmer, PT

  • Pediatric Physical Therapist
  • Miami, FL
National Provider Identifier
1174575260
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
17965 Issued in FL
Practice address
15207 SW 176TH LN
Miami, FL 33187-1620
Phone
(305) 209-5050
Fax
(305) 235-5050
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT17965 FL
Pediatric Physical Therapist 2251P0200X 17965 FL Primary

Addresses

Primary practice location

15207 SW 176TH LN
Miami, FL 33187-1620

Mailing address

15207 SW 176TH LN
Miami, FL 33187-1620
Phone (305) 562-4493

Other identifiers 1

IdentifierTypeStateIssuer
004481800MedicaidFL

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

LicenseStateTypeSpecialty
17965FLMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Waipahu Physical Therapy, Inc Physical Therapist Past Accepting new patients
Wahiawa Rehab Services Inc Physical Therapist PastSince Feb 22, 2010 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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1174575260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15207 SW 176TH LN",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331871620",
            "telephone_number": "305-562-4493",
            "fax_number": "305-235-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15207 SW 176TH LN",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331871620",
            "telephone_number": "305-209-5050",
            "fax_number": "305-235-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "LOURDES",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT17965",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "FL",
            "license": "17965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004481800",
            "state": "FL"
        }
    ],
    "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 4, 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.

Verify at the official NPI Registry.