Individual provider Active NPI

Michelle Tiezzi Galhardo Viana

  • Physical Therapist
  • Bonita Springs, FL
National Provider Identifier
1265158117
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
38750 Issued in FL
Practice address
3725 Bonita Beach Rd Ste 2
Bonita Springs, FL 34134-1400
Phone
(810) 853-9246
NPI assigned
Oct 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 38750 FL Primary

Addresses

Primary practice location

3725 Bonita Beach Rd Ste 2
Bonita Springs, FL 34134-1400

Mailing address

190 2ND St
Bonita Springs, FL 34134-7360
Phone (407) 235-0318

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

LicenseStateTypeSpecialty
38750FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1265158117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 2ND ST",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341347360",
            "telephone_number": "407-235-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3725 BONITA BEACH RD STE 2",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341341400",
            "telephone_number": "810-853-9246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEZZI GALHARDO VIANA",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "38750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.