Keith R. Madonia, P.a.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT19334 Issued in FL

Legal business name

KEITH R. MADONIA, P.A.

Doing business as

Optimum Physical Therapy

Practice address

2042 SW Providence PL
Port St Lucie, FL 34953-4385

Phone

(305) 310-3702

NPI assigned

Nov 3, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Keith Ryan Madonia, P.T.

Title

Owner

Phone

(305) 310-3702

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Optimum Physical Therapy Doing business as

Practitioners 1

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

• Tatiana C Madonia, PT

  • Physical Therapist
  • Port St Lucie, FL
  • NPI 1073639902
  NPD (past)

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

{
    "created_epoch": "1414972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430438400000",
    "number": "1417352485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2042 SW PROVIDENCE PL",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349534385",
            "telephone_number": "305-310-3702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2042 SW PROVIDENCE PL",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349534385",
            "telephone_number": "305-310-3702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH R. MADONIA, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-03",
        "last_updated": "2015-05-01",
        "status": "A",
        "authorized_official_last_name": "MADONIA",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-310-3702",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT19334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IB393A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optimum Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jacqueline Kaylor
• Joseph Kazmer, R.PH.
• Christine Geralyn Kee
• Natalie Keegan, ARNP
• Keep Safe Transport
• Theresa Kello
• Carissa Kelly
• Christine Kelly, RN
• Kristy Kelly
• Line Kemeyou, MD

• Physical Therapist in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; 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.