NPIMap

Organization Active NPI

Proficio Therapy Center, Inc.

  • Physical Therapist
  • Weston, FL
National Provider Identifier
1417040726
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 21147 Issued in FL
Legal business name
PROFICIO THERAPY CENTER, INC.
Practice address
1040 Weston Rd Ste 307
Weston, FL 33326-1912
Phone
(954) 376-1511
Fax
(915) 773-4874
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Jennifer May Van Gent, P.T.NPI 1073730222
Title
Director/ President
Phone
(954) 376-1511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT 21147 FL Primary

Addresses

Primary practice location

1040 Weston Rd Ste 307
Weston, FL 33326-1912

Mailing address

1040 Weston Rd Ste 307
Weston, FL 33326-1912
Phone (954) 376-1511

Other names 1

  • Mii Amo Therapy Associates, Inc. Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Mii Amo Therapy Associates Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417040726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 WESTON RD STE 307",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333261912",
            "telephone_number": "954-376-1511",
            "fax_number": "915-773-4874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 WESTON RD STE 307",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333261912",
            "telephone_number": "954-376-1511",
            "fax_number": "915-773-4874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFICIO THERAPY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VAN GENT",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "MAY",
        "authorized_official_title_or_position": "DIRECTOR/ PRESIDENT",
        "authorized_official_telephone_number": "954-376-1511",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT 21147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mii Amo Therapy Associates, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Weston, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.