Natalia Gabriela Moctezuma

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT39102 Issued in FL

Practice address

13801 Walsingham Rd Ste G
Largo, FL 33774-3237

Phone

(727) 593-7909

NPI assigned

Mar 5, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Networks

• Optimum HealthCare HMO Network

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1194227264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13670 HIDDEN FOREST CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328286815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13801 WALSINGHAM RD STE G",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337743237",
            "telephone_number": "727-593-7909"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13670 Hidden Forest Cir",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328286815",
            "country_code": "US",
            "telephone_number": "407-967-2067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOCTEZUMA",
        "first_name": "NATALIA",
        "middle_name": "GABRIELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-05",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL5329",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT39102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Genc Mita, PHARM D
• Kelsey Elisabeth Mitchell, APRN, FNP-C
• Benedetto Mitrano, PHARM. D.
• Meir Mizrahi, MD
• MKS Medical Supply, Inc
• Modern Chiropractic Solutions LLC
• Sara C Mohama
• John Moldt, DDS
• Kimberly Queen Moldt, M.A.
• Mona Ido LMHC, PA

• Physical Therapist in Largo, FL
• Providers in Largo, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.

Verify at the official NPI Registry.