Leonardo Gonzalez Bahamonde

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA32051 Issued in FL

Practice address

2808 Lithia Pinecrest Rd
Valrico, FL 33596-5615

Phone

(813) 573-2905

NPI assigned

Sep 14, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1663113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1205558467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 ESSEX RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335102735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 LITHIA PINECREST RD",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335965615",
            "telephone_number": "813-573-2905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ BAHAMONDE",
        "first_name": "LEONARDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-14",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA32051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Denise Givens, PTA
• Alicia Marie Glasser
• Lauren Glenn
• Amanda Beth Gomer
• Marcia S Gomez
• Laura Gil Gonzalez, ARNP
• Good Faith Home Care LLC
• Gorham Therapy Services
• Gorham Therapy Services
• Sajani Goyal, MSN, APRN, FNP-C

• Physical Therapy Assistant in Valrico, FL
• Providers in Valrico, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.