Sergio E Valdivia, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT10727 Issued in FL

Practice address

12355 SW County Road 769
Suite B
Lake Suzy, FL 34269-5923

Phone

(941) 468-1660

Fax

(941) 484-6024

NPI assigned

Aug 11, 2005

Last updated

Jun 23, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Florida Physical Therapy Specialists Port Charlotte Inc.

  • Physical Therapist
  • Punta Gorda, FL
  • NPI 1548262488
  Medicare reassignment NPD Authorized official
• Spinal Integrated Medicine, LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Punta Gorda, FL
  • NPI 1689079709

  Physical Therapist

  NPD (past)
• Voice Aerobics LLC

  • Speech-Language Pathologist
  • Punta Gorda, FL
  • NPI 1184858938
  NPD (past)

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1225030166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1551",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342841551",
            "telephone_number": "941-468-1660",
            "fax_number": "941-484-6024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12355 SW COUNTY ROAD 769",
            "address_2": "SUITE B",
            "city": "LAKE SUZY",
            "state": "FL",
            "postal_code": "342695923",
            "telephone_number": "941-468-1660",
            "fax_number": "941-484-6024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDIVIA",
        "first_name": "SERGIO",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT10727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y053N",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BCBS",
            "identifier": "001872584",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arcadia Chiropractic Clinic, Inc
• Terence Vaughan Connors, PA
• Florida Psych Services Inc.

• Physical Therapist in Lake Suzy, FL
• Providers in Lake Suzy, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.