Individual provider Active NPI

Marla Gonzalez, DPT

  • Physical Therapist
  • Doral, FL
National Provider Identifier
1295590057
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT40814 Issued in FL
Practice address
2000 NW 87TH Ave Ste 216
Doral, FL 33172-2657
Phone
(786) 359-4999
Fax
(786) 359-4843
NPI assigned
Feb 20, 2024
Last updated
Feb 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT40814 FL Primary

Addresses

Primary practice location

2000 NW 87TH Ave Ste 216
Doral, FL 33172-2657

Mailing address

2000 NW 87TH Ave Ste 216
Doral, FL 33172-2657
Phone (786) 359-4999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240423000494 FL Practitioner - Physical Therapist in Private Practice 3971942046 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT40814FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Luna Care Physical Therapy LLC Physical Therapist CurrentSince Mar 10, 2024 Accepting new patients
Tamiami Rehab Center Corp Physical Therapist PastSince Feb 25, 2024 Accepting new patients

Locations

5011 Gate Pkwy
Ste 100
Jacksonville, FL 32256
Phone (904) 326-3627

5401 W Kennedy Blvd
Ste 100
Tampa, FL 33609
Phone (813) 323-1959

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1295590057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 NW 87TH AVE STE 216",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331722657",
            "telephone_number": "786-359-4999",
            "fax_number": "786-359-4843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 NW 87TH AVE STE 216",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331722657",
            "telephone_number": "786-359-4999",
            "fax_number": "786-359-4843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "MARLA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT40814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.