Individual provider Active NPI

Sebastian Fuentes, PTA

  • Physical Therapy Assistant
  • Miami, FL
National Provider Identifier
1194599233
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA32434 Issued in FL
Practice address
601 SW 8TH St
Miami, FL 33130-3308
Phone
(305) 967-3451
NPI assigned
Nov 9, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA32434 FL Primary

Addresses

Primary practice location

601 SW 8TH St
Miami, FL 33130-3308

Mailing address

126 Madeira Ave
Coral Gables, FL 33134-4516
Phone (305) 342-4270

Other practice location 1

126 Madeira Ave
Coral Gables, FL 33134-4516
Phone (305) 342-4270

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
PTA32434FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gables Therapy & Wellness Center CurrentSince Nov 12, 2023 Accepting new patients

Locations

126 Madeira Ave
Coral Gables, FL 33134
Phone (305) 342-4270

Organizations & group practices 1

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": "1699488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1194599233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 MADEIRA AVE",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331344516",
            "telephone_number": "305-342-4270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 SW 8TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331303308",
            "telephone_number": "305-967-3451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "126 Madeira Ave",
            "address_purpose": "LOCATION",
            "city": "Coral Gables",
            "state": "FL",
            "postal_code": "331344516",
            "country_code": "US",
            "telephone_number": "305-342-4270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "SEBASTIAN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-09",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA32434",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 9, 2023; 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.