Carolina Mesa Derose, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT019923 Issued in PA

Practice address

780 W Lincoln Hwy
Exton, PA 19341-2547

Phone

(610) 873-4856

Fax

(610) 873-4859

NPI assigned

Dec 14, 2009

Last updated

Dec 14, 2009By 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 1

Addresses

Other names 1

• Miss Carolina Mesa Lizarazo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1260748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260748800000",
    "number": "1366771776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 BUCKEYE LN",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193826119",
            "telephone_number": "757-645-8368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 W LINCOLN HWY",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193412547",
            "telephone_number": "610-873-4856",
            "fax_number": "610-873-4859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSE",
        "first_name": "CAROLINA",
        "middle_name": "MESA",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-14",
        "last_updated": "2009-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "PA",
            "license": "PT019923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLINA",
            "last_name": "LIZARAZO",
            "middle_name": "MESA",
            "prefix": "MISS",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dennis John Deloretta, D.C.
• Nicole Dematto, CRNP
• Denise Marino (CDM-PT, Inc)
• John Kenneth Denlinger, MD
• Dermatology and Skin Surgery Center, PC
• Designed for Health Chiropractic Clinic PC
• Jeanette Desilva, LPC
• Wendy Robin Deutsch, PSY.D.
• Tara Devoy, CRNP
• Thomas Michael Devries, D.C.

• Orthopedic Physical Therapist in Exton, PA
• Providers in Exton, PA by specialty
• Orthopedic Physical Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; 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.