Active NPI
Enrique Lemus
- Physical Therapy Assistant
- Port Charlotte, FL
National Provider Identifier
1295250082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA20156
- 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
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 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
| License | State | Type | Specialty |
|---|---|---|---|
| PTA20156 | FL | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ultimate Wellness Rehab LLC | Physical Therapist | Current | 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.
-
- Physical Therapy Clinic/Center
- Port Charlotte, FL
- NPI 1689011488
Physical Therapist
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.