Keith Pacific

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT24790 Issued in FL

Practice address

2964 Lowell CT
Casselberry, FL 32707-5881

Phone

(321) 972-8685

Fax

(407) 241-2868

NPI assigned

Apr 22, 2008

Last updated

Jul 6, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246838400000",
    "number": "1427223353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2964 LOWELL CT",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327075881",
            "telephone_number": "321-972-8685",
            "fax_number": "407-241-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2964 LOWELL CT",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327075881",
            "telephone_number": "321-972-8685",
            "fax_number": "407-241-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACIFIC",
        "first_name": "KEITH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-22",
        "last_updated": "2009-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "030135",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT24790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Casselberry, FL
• Providers in Casselberry, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2009; 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.