Individual provider Active NPI

Janysca Valdes, LMT

  • Physical Therapy Clinic/Center
  • Lehigh Acres, FL
National Provider Identifier
1174950224
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
MA 64798 Issued in FL
Practice address
5520 Berryman St
Lehigh Acres, FL 33971-6401
Phone
(305) 926-4794
Fax
(239) 481-2209
NPI assigned
Oct 3, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X MA 64798 FL Primary

Addresses

Primary practice location

5520 Berryman St
Lehigh Acres, FL 33971-6401

Mailing address

5520 Berryman St
Lehigh Acres, FL 33971-6401
Phone (305) 926-4794

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
MA 64798FLMDPhysical Therapy Clinic/Center

NPI Registry JSON

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

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1174950224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5520 BERRYMAN ST",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339716401",
            "telephone_number": "305-926-4794",
            "fax_number": "239-481-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 BERRYMAN ST",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339716401",
            "telephone_number": "305-926-4794",
            "fax_number": "239-481-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDES",
        "first_name": "JANYSCA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-03",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "MA 64798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehigh Acres, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; 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.