Individual provider Active NPI

Dana Marie Pedroza, P.T.A

  • Physical Therapy Assistant
  • Oviedo, FL
National Provider Identifier
1174796197
Registry record updated Oct 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA20887 Issued in FL
Practice address
7400 Red Bug Lake Rd
Oviedo, FL 32765-7154
Phone
(407) 971-2774
NPI assigned
Apr 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA20887 FL Primary
Massage Therapist 225700000X MA 34486 FL

Addresses

Primary practice location

7400 Red Bug Lake Rd
Oviedo, FL 32765-7154

Mailing address

151 Lynn St
Oviedo, FL 32765-7486
Phone (321) 948-8990

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
PTA20887FLMDPhysical Therapy Assistant
MA 34486FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256169600000",
    "number": "1174796197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 LYNN ST",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327657486",
            "telephone_number": "321-948-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 RED BUG LAKE RD",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327657154",
            "telephone_number": "407-971-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDROZA",
        "first_name": "DANA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "P.T.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-10",
        "last_updated": "2009-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA20887",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA 34486",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2009; 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.