Premier Physical Therapy LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

PREMIER PHYSICAL THERAPY LLC

Doing business as

Physical Therapy Now Coral Gables

Practice address

2690 SW 22ND St Unit 3
Coral Gables, FL 33145-3406

Phone

(305) 570-1666

Fax

(305) 203-0546

NPI assigned

Aug 17, 2018

Organization subpart

No

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

Authorized official

Name

Daylin Revilla, PTA

Title

Owner

Phone

(305) 570-1666

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Physical Therapy Now Coral Gables Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Physical Therapy Now2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Premier Physical Therapy

  • Clinic/Center
  • Miami, FL
  • NPI 1407359870
  NPD tax ID

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Evelyn Capdevila, MPT

  • Physical Therapist
  • Hialeah, FL
  • NPI 1821235854
  Medicare reassignment Care Compare group NPD
• Carlos Luis Nicado, DPT

  • Physical Therapist
  • Miami, FL
  • NPI 1396349064
  Medicare reassignment Care Compare group NPD
• Andres Zapata, O.T.

  • Occupational Therapist
  • Doral, FL
  • NPI 1750328316
  Medicare reassignment Care Compare group NPD
• Jenny De Marziani, PT

  • Physical Therapist
  • Grain Valley, MO
  • NPI 1063598530

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549497600000",
    "number": "1316427461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 SW 22ND ST UNIT 3",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331453406",
            "telephone_number": "305-570-1666",
            "fax_number": "305-203-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 SW 22ND ST UNIT 3",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331453406",
            "telephone_number": "305-570-1666",
            "fax_number": "305-203-0546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-17",
        "last_updated": "2019-02-07",
        "status": "A",
        "authorized_official_last_name": "REVILLA",
        "authorized_official_first_name": "DAYLIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-570-1666",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT26790",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PTA24456",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physical Therapy Now Coral Gables",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Coral Gables, FL
• Providers in Coral Gables, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; 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.