Active NPI
Lourdes M Palmer, PT
- Pediatric Physical Therapist
- Miami, FL
National Provider Identifier
1174575260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 17965
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004481800 | Medicaid | FL |
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 |
|---|---|---|---|
| 17965 | FL | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Waipahu Physical Therapy, Inc | Physical Therapist | Past | Accepting new patients |
| Wahiawa Rehab Services Inc | Physical Therapist | Past | 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.
-
- Physical Therapist
- Wahiawa, HI
- NPI 1306919964
-
- Physical Therapist
- Waipahu, HI
- NPI 1255410650
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.