Carlo Gabriel Avena, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT36599 Issued in FL

Practice address

1337 S International Pkwy Ste 1321
Lake Mary, FL 32746-1402

Phone

(407) 833-0802

NPI assigned

Nov 18, 2020

Sex

Male

Sole proprietor

No

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)

Not enrolled

State licenses

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1295338788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 BROAD ST STE 203",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301613006",
            "telephone_number": "407-833-0802",
            "fax_number": "407-833-8931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1337 S INTERNATIONAL PKWY STE 1321",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461402",
            "telephone_number": "407-833-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVENA",
        "first_name": "CARLO",
        "middle_name": "GABRIEL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT36599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebekah R Atkins, NP-C
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• Emily Azhar
• Maria Aziz

• Physical Therapist in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.