Active NPI
Marcelo Ablaza
- Physical Therapist
- West Melbourne, FL
National Provider Identifier
1275885220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT26742
- Practice address
- 3952 Joslin Way
West Melbourne, FL 32904-8489 - Phone
- (954) 257-9545
- NPI assigned
- Oct 15, 2012
- Last updated
- Oct 15, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 | PT26742 | FL | Primary |
Addresses
Primary practice location
3952 Joslin Way
West Melbourne, FL 32904-8489
Mailing address
3952 Joslin Way
West Melbourne, FL 32904-8489
Phone (954) 257-9545
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT26742 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350259200000",
"number": "1275885220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3952 JOSLIN WAY",
"city": "WEST MELBOURNE",
"state": "FL",
"postal_code": "329048489",
"telephone_number": "954-257-9545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3952 JOSLIN WAY",
"city": "WEST MELBOURNE",
"state": "FL",
"postal_code": "329048489",
"telephone_number": "954-257-9545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ABLAZA",
"first_name": "MARCELO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-10-15",
"last_updated": "2012-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT26742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.