Active NPI
Gueorgui Ivanov Petrov, MSPT
- Physical Therapist
- Deerfield Beach, FL
National Provider Identifier
1427125046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 22949
- Practice address
- 2259 W Hillsboro Blvd
Deerfield Beach, FL 33442-1106 - Phone
- (954) 725-4160
- Fax
- (954) 725-4838
- NPI assigned
- Nov 29, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 Therapist | 225100000X | 22949 | FL | Primary |
Addresses
Primary practice location
2259 W Hillsboro Blvd
Deerfield Beach, FL 33442-1106
Mailing address
4205 NW 73Rd Way
Coral Springs, FL 33065-2156
Phone (954) 478-9993
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 |
|---|---|---|---|
| 22949 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1427125046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4205 NW 73RD WAY",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330652156",
"telephone_number": "954-478-9993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2259 W HILLSBORO BLVD",
"city": "DEERFIELD BEACH",
"state": "FL",
"postal_code": "334421106",
"telephone_number": "954-725-4160",
"fax_number": "954-725-4838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETROV",
"first_name": "GUEORGUI",
"middle_name": "IVANOV",
"name_prefix": "Mr.",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "22949",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deerfield Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.