Active NPI
Kimberly Mudano, PT
- Physical Therapy Assistant
- Palm Harbor, FL
National Provider Identifier
1417757642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 1489
- Practice address
- 2960 Tampa Rd
Palm Harbor, FL 34684-3340 - Phone
- (727) 743-1953
- NPI assigned
- Mar 17, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 1489 | FL | Primary |
Addresses
Primary practice location
2960 Tampa Rd
Palm Harbor, FL 34684-3340
Mailing address
1444 Haverhill Dr
New Port Richey, FL 34655-4233
Phone (727) 271-2123
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1489 | FL | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744675200000",
"number": "1417757642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1444 HAVERHILL DR",
"city": "NEW PORT RICHEY",
"state": "FL",
"postal_code": "346554233",
"telephone_number": "727-271-2123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2960 TAMPA RD",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "346843340",
"telephone_number": "727-743-1953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUDANO",
"first_name": "KIMBERLY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-03-17",
"last_updated": "2025-04-15",
"certification_date": "2025-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "1489",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Harbor, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.