Active NPI
Justin Bonazinca
- Physical Therapist
- Orlando, FL
National Provider Identifier
1205186475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 27515
- Practice address
- 5671 S Orange Ave
Orlando, FL 32809 - Phone
- (407) 888-2255
- NPI assigned
- Sep 14, 2012
- Last updated
- Sep 14, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 27515 | FL | Primary |
Addresses
Primary practice location
5671 S Orange Ave
Orlando, FL 32809
Mailing address
15635 Expedition St.
Winter Garden, FL 34787
Phone (772) 370-9926
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 |
|---|---|---|---|
| 27515 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Durable Medical Equipment Specialists | Past | Accepting new patients | |
| Physical Therapy Specialists of Pine Castle LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Durable Medical Equipment & Medical Supplies
- Orlando, FL
- NPI 1063787190
-
- Physical Therapist
- Orlando, FL
- NPI 1548217615
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347580800000",
"number": "1205186475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15635 EXPEDITION ST.",
"city": "WINTER GARDEN",
"state": "FL",
"postal_code": "34787",
"telephone_number": "772-370-9926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5671 S ORANGE AVE",
"city": "ORLANDO",
"state": "FL",
"postal_code": "32809",
"telephone_number": "407-888-2255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONAZINCA",
"first_name": "JUSTIN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-14",
"last_updated": "2012-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "27515",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.