Individual provider Active NPI

Pantaleon Delrosario, LPTA

  • Physical Therapy Assistant
  • Winter Haven, FL
National Provider Identifier
1306134390
Registry record updated Jul 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA20660 Issued in FL
Practice address
1201 Eagle Pond Dr
Winter Haven, FL 33884-1296
Phone
(863) 521-1909
NPI assigned
Jul 12, 2011
Last updated
Jul 12, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2011

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 PTA20660 FL Primary

Addresses

Primary practice location

1201 Eagle Pond Dr
Winter Haven, FL 33884-1296

Mailing address

1201 Eagle Pond Dr
Winter Haven, FL 33884-1296
Phone (863) 521-1909

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
PTA20660FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310428800000",
    "number": "1306134390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 EAGLE POND DR",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338841296",
            "telephone_number": "863-521-1909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 EAGLE POND DR",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338841296",
            "telephone_number": "863-521-1909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELROSARIO",
        "first_name": "PANTALEON",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-12",
        "last_updated": "2011-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA20660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2011; 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.