Active NPI
Ted Santiago Pasco
- Occupational Therapist
- Orlando, FL
National Provider Identifier
1376004697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 056012806
- Practice address
- 3452 Lake Lynda Dr Ste 200
Orlando, FL 32817-1481 - Phone
- (800) 774-7785
- NPI assigned
- Mar 28, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 | 056012806 | IL | Primary |
Addresses
Primary practice location
3452 Lake Lynda Dr Ste 200
Orlando, FL 32817-1481
Mailing address
130 E Cox St Apt 3
Forsyth, IL 62535-8952
Phone (407) 627-6689
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
| License | State | Type | Specialty |
|---|---|---|---|
| 056012806 | IL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553731200000",
"number": "1376004697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 E COX ST APT 3",
"city": "FORSYTH",
"state": "IL",
"postal_code": "625358952",
"telephone_number": "407-627-6689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3452 LAKE LYNDA DR STE 200",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328171481",
"telephone_number": "800-774-7785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASCO",
"first_name": "TED",
"middle_name": "SANTIAGO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-28",
"last_updated": "2019-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IL",
"license": "056012806",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.