Roosevelt Moore, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT14852 Issued in FL

Practice address

6883 SW 194TH Ave
Fort Lauderdale, FL 33332-1638

Phone

(305) 968-5622

NPI assigned

Jul 28, 2008

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)

Enrolled

State licenses

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217203200000",
    "number": "1265697304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6883 SW 194TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333321638",
            "telephone_number": "305-968-5622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6883 SW 194TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333321638",
            "telephone_number": "305-968-5622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ROOSEVELT",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-28",
        "last_updated": "2008-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT14852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• January Moore
• Julie Isabella Moore, LMFT
• Keith Erickson Moore, DMD
• Martha F Moore, L.M.T.
• Ronald E Moore Jr., MD
• Taryll Leon Moore Jr.
• Theola Moore, MS, MHC
• Melodie Kay Moorehead, PH.D.,ABPP
• Erika Michele Moorman, M.S.,CCC-SLP
• Jessica Mora, ATC, CSCS

• Physical Therapist in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; 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.