Individual provider Active NPI

Gabriel Carvajal Jr., MPT

  • Physical Therapist
  • Miami, FL
National Provider Identifier
1407059868
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT20822 Issued in FL
Practice address
6812 SW 81St St
Miami, FL 33143-7708
Phone
(305) 768-9134
Fax
(786) 338-7421
NPI assigned
Jun 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT20822 FL Primary

Addresses

Primary practice location

6812 SW 81St St
Miami, FL 33143-7708

Mailing address

9431 SW 54TH St
Miami, FL 33165-6415
Phone (305) 905-4188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200320000624 FL Practitioner - Physical Therapist in Private Practice 5193153492 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
May accept Medicare assignment
Group practices
South Florida Rehab and Training Center Inc.Group PAC ID 4284062589, 2 clinicians

Practice addresses (Care Compare)

6812 SW 81St St
Miami, FL 33143-7708
Phone (305) 768-9134

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Rehab & Training Center Inc. Physical Therapist CurrentSince Feb 1, 2020 Accepting new patients
South Florida Rehab and Training Center Past Accepting new patients
South Florida Rehab and Training Center Past Accepting new patients

Locations

6812 SW 81st St
Miami, FL 33143
Phone (305) 768-9134

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": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1407059868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9431 SW 54TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331656415",
            "telephone_number": "305-905-4188",
            "fax_number": "305-595-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6812 SW 81ST ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331437708",
            "telephone_number": "305-768-9134",
            "fax_number": "786-338-7421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARVAJAL",
        "first_name": "GABRIEL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT20822",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.