Individual provider Active NPI

John Liber Mosquera Castro, CP/LP

  • Specialist
  • Boca Raton, FL
National Provider Identifier
1396297982
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PRO 174 Issued in FL
Practice address
1700 N Dixie Hwy Ste 107
Boca Raton, FL 33432-1807
Phone
(754) 244-4028
Fax
(855) 611-8511
NPI assigned
Oct 28, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PRO 174 FL Primary

Addresses

Primary practice location

1700 N Dixie Hwy Ste 107
Boca Raton, FL 33432-1807

Mailing address

1700 N Dixie Hwy Ste 107
Boca Raton, FL 33432-1807
Phone (754) 244-4028

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

LicenseStateTypeSpecialty
PRO 174FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Prosthetic Technology Center, Inc Current Accepting new patients
Prosthetic Technology Center Current Accepting new patients
Caliber Medical Supply LLC PastSince Sep 6, 2020 Accepting new patients

Locations

1700 N Dixie Hwy
Ste 107
Boca Raton, FL 33432
Phone (562) 373-8667

Organizations & group practices 3

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": "1477612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1396297982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 N DIXIE HWY STE 107",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334321807",
            "telephone_number": "754-244-4028",
            "fax_number": "855-611-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N DIXIE HWY STE 107",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334321807",
            "telephone_number": "754-244-4028",
            "fax_number": "855-611-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSQUERA CASTRO",
        "first_name": "JOHN",
        "middle_name": "LIBER",
        "credential": "CP/LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-28",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "PRO 174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; 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.