Haelim Park

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA01701100 Issued in NJ

Practice address

5535 S Williamson Blvd
Suite 774
Port Orange, FL 32128-8311

Phone

(888) 265-2680

NPI assigned

Feb 28, 2017

Last updated

Feb 28, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488240000000",
    "number": "1336689041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 ROYDEN ST",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031419",
            "telephone_number": "201-207-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 S WILLIAMSON BLVD",
            "address_2": "SUITE 774",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321288311",
            "telephone_number": "888-265-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "HAELIM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-28",
        "last_updated": "2017-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA01701100",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT024875",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Kirby PA (Dr Pamel Kirby DPM)
• John Michael Panczyszyn, D.D.S.
• Paradise Family Practice LLC
• Elizabeth Parish
• Rose Parish
• Parker Integrative Medicine, LLC
• Lindsey Parker
• Cynthia Ann Parkes, MS, LMHC
• Joan Parnell
• Harison Rafael Parra, MD

• Physical Therapist in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; 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.