Active NPI
Angela Joy Prodanov, MPT
- Physical Therapist
- Marco Island, FL
National Provider Identifier
1265998702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT25395
- Practice address
- 101 Sand Hill St
Marco Island, FL 34145-4614 - Phone
- (239) 394-9622
- NPI assigned
- Feb 20, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT25395 | FL | Primary |
Addresses
Primary practice location
101 Sand Hill St
Marco Island, FL 34145-4614
Mailing address
196 Columbus Way
Marco Island, FL 34145-5102
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550620800000",
"number": "1265998702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "196 COLUMBUS WAY",
"city": "MARCO ISLAND",
"state": "FL",
"postal_code": "341455102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 SAND HILL ST",
"city": "MARCO ISLAND",
"state": "FL",
"postal_code": "341454614",
"telephone_number": "239-394-9622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRODANOV",
"first_name": "ANGELA",
"middle_name": "JOY",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-20",
"last_updated": "2019-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT25395",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marco Island, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.