Active NPI
Rodolfo Maduro
- Physical Therapist
- Tampa, FL
National Provider Identifier
1356451207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 4107 N Himes Ave
Ste 100
Tampa, FL 33607-6655 - Phone
- (813) 874-1009
- NPI assigned
- Aug 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
4107 N Himes Ave
Ste 100
Tampa, FL 33607-6655
Mailing address
3804 Dogtrot St
New Port Richey, FL 34655-2063
Phone (727) 376-8893
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT17781 | Other | FL | LICENSE# |
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
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356451207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3804 DOGTROT ST",
"city": "NEW PORT RICHEY",
"state": "FL",
"postal_code": "346552063",
"telephone_number": "727-376-8893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4107 N HIMES AVE",
"address_2": "STE 100",
"city": "TAMPA",
"state": "FL",
"postal_code": "336076655",
"telephone_number": "813-874-1009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADURO",
"first_name": "RODOLFO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE#",
"identifier": "PT17781",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.