Individual provider Active NPI

Orlando Jimenez Jr., PTA

  • Physical Therapy Assistant
  • Miami Lakes, FL
National Provider Identifier
1245471903
Registry record updated Oct 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA18697 Issued in FL
Practice address
15600 NW 67TH Ave
Suite 306
Miami Lakes, FL 33014-2174
Phone
(954) 476-8800
Fax
(954) 476-1362
NPI assigned
Mar 10, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2009

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 PTA18697 FL Primary

Addresses

Primary practice location

15600 NW 67TH Ave
Suite 306
Miami Lakes, FL 33014-2174

Mailing address

350 N Pine Island Rd
Suite 200
Plantation, FL 33324-1849
Phone (954) 476-8800

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
PTA18697FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1236643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256169600000",
    "number": "1245471903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N PINE ISLAND RD",
            "address_2": "SUITE 200",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333241849",
            "telephone_number": "954-476-8800",
            "fax_number": "954-476-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15600 NW 67TH AVE",
            "address_2": "SUITE 306",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330142174",
            "telephone_number": "954-476-8800",
            "fax_number": "954-476-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIMENEZ",
        "first_name": "ORLANDO",
        "name_suffix": "Jr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-10",
        "last_updated": "2009-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA18697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2009; 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.