Individual provider Active NPI

Javier Jesus Gonzalez, PTA

  • Physical Therapy Assistant
  • Miami Lakes, FL
National Provider Identifier
1326698093
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
29751 Issued in FL
Practice address
7401 Miami Lakes Dr
Miami Lakes, FL 33014-6818
Phone
(786) 500-7868
Fax
(305) 512-6061
NPI assigned
Sep 16, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 225200000X 29751 FL Primary

Addresses

Primary practice location

7401 Miami Lakes Dr
Miami Lakes, FL 33014-6818

Mailing address

15579 Miami Lakeway N Apt 102
Miami Lakes, FL 33014-5588
Phone (786) 390-0878

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
29751FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1326698093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15579 MIAMI LAKEWAY N APT 102",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330145588",
            "telephone_number": "786-390-0878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 MIAMI LAKES DR",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330146818",
            "telephone_number": "786-500-7868",
            "fax_number": "305-512-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "JAVIER",
        "middle_name": "JESUS",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-16",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "29751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.