Individual provider Active NPI

Jenevieve Serilo Oquendo

  • Physical Therapist
  • West Melbourne, FL
National Provider Identifier
1417102724
Registry record updated Sep 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
7201 Greenboro Dr
West Melbourne, FL 32904-1698
Phone
(321) 727-0990
NPI assigned
Dec 1, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2012

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 Primary

Addresses

Primary practice location

7201 Greenboro Dr
West Melbourne, FL 32904-1698

Mailing address

3952 Joslin Way
West Melbourne, FL 32904-8489
Phone (858) 429-8638

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

NPI Registry JSON

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346976000000",
    "number": "1417102724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3952 JOSLIN WAY",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329048489",
            "telephone_number": "858-429-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7201 GREENBORO DR",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329041698",
            "telephone_number": "321-727-0990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OQUENDO",
        "first_name": "JENEVIEVE",
        "middle_name": "SERILO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2012-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2012; 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.