Individual provider Active NPI

Lisa Grilliot

  • Physical Therapist
  • Pembroke Pines, FL
National Provider Identifier
1427168392
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
17796 SW 2ND St
Pembroke Pines, FL 33029-3923
Phone
(954) 438-7800
NPI assigned
Aug 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

17796 SW 2ND St
Pembroke Pines, FL 33029-3923

Mailing address

11790 SW 25TH St
Davie, FL 33325-4800
Phone (954) 472-7209

Other identifiers 1

IdentifierTypeStateIssuer
PT7311OtherFLLICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230405002821 FL Practitioner - Physical Therapist in Private Practice 3173998135 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabclinics Pta, Inc. Current Accepting new patients
Rehabclinics Pta, Inc. CurrentSince Oct 1, 2023 Accepting new patients
Rehabclinics Pta, Inc. CurrentSince Oct 1, 2023 Accepting new patients
Clear Choice Physical Therapy,Inc Physical Therapist CurrentSince Jul 31, 2023 Accepting new patients
Clear Choice Physical Therapy, Inc. CurrentSince Jul 31, 2023 Accepting new patients

Locations

1817 E Commercial Blvd
Ft Lauderdale, FL 33308
Phone (954) 836-8980

2840 E Oakland Park Blvd
Ft Lauderdale, FL 33306
Phone (954) 565-0075

5975 N Federal Hwy
Ste 244
Ft Lauderdale, FL 33308
Phone (954) 491-7606

17796 SW 2nd St
Pembroke Pines, FL 33029
Phone (954) 438-6437

Networks

  • Freedom Health HMO Network

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427168392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11790 SW 25TH ST",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333254800",
            "telephone_number": "954-472-7209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17796 SW 2ND ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330293923",
            "telephone_number": "954-438-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRILLIOT",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "PT7311",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.