Individual provider Active NPI

Enrique Lemus

  • Physical Therapy Assistant
  • Port Charlotte, FL
National Provider Identifier
1295250082
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA20156 Issued in FL
Practice address
3524 Tamiami TRL Ste 103
Port Charlotte, FL 33952-8155
Phone
(941) 764-9695
Fax
(941) 764-9694
NPI assigned
Aug 14, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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 PTA20156 FL Primary

Addresses

Primary practice location

3524 Tamiami TRL Ste 103
Port Charlotte, FL 33952-8155

Mailing address

3524 Tamiami Trail
Suite 103
Port Charlotte, FL 33952-8155
Phone (941) 764-9695

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
PTA20156FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ultimate Wellness Rehab LLC Physical Therapist CurrentSince Jun 23, 2025 Accepting new patients

Locations

18308 Murdock Cir
Unit 107
Pt Charlotte, FL 33948
Phone (941) 764-9695

3524 Tamiami Trl
Ste 103
Pt Charlotte, FL 33952
Phone (941) 625-4801

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1502668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1295250082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3524 TAMIAMI TRAIL",
            "address_2": "SUITE 103",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339528155",
            "telephone_number": "941-764-9695",
            "fax_number": "941-764-9694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3524 TAMIAMI TRL STE 103",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339528155",
            "telephone_number": "941-764-9695",
            "fax_number": "941-764-9694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMUS",
        "first_name": "ENRIQUE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-14",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA20156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2025; 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.