Active NPI
Bernardo Jesus Delriesgo, MOT, OTR/L
- Occupational Therapist
- Miami, FL
National Provider Identifier
1366527699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT8339
- Practice address
- 14291 SW 120TH St Ste 103
Miami, FL 33186-7287 - Phone
- (305) 385-0168
- Fax
- (305) 385-0182
- NPI assigned
- Oct 26, 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT8339 | FL | Primary |
Addresses
Primary practice location
14291 SW 120TH St Ste 103
Miami, FL 33186-7287
Mailing address
14291 SW 120TH St Ste 103
Miami, FL 33186-7287
Phone (305) 385-0168
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 887059400 | Medicaid | FL |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT8339 | FL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Activa, LC | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647216000000",
"number": "1366527699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14291 SW 120TH ST STE 103",
"city": "MIAMI",
"state": "FL",
"postal_code": "331867287",
"telephone_number": "305-385-0168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14291 SW 120TH ST STE 103",
"city": "MIAMI",
"state": "FL",
"postal_code": "331867287",
"telephone_number": "305-385-0168",
"fax_number": "305-385-0182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELRIESGO",
"first_name": "BERNARDO",
"middle_name": "JESUS",
"name_prefix": "Mr.",
"credential": "MOT, OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2022-03-14",
"certification_date": "2022-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT8339",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "887059400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.