NPIMap

Organization Active NPI

Envision Physical Therapy, Inc

  • Clinic/Center
  • Lake Mary, FL
National Provider Identifier
1437301025
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
PT17963 Issued in FL
Legal business name
ENVISION PHYSICAL THERAPY, INC
Practice address
956 International Pkwy Ste 1580
Lake Mary, FL 32746-5219
Phone
(407) 936-0314
Fax
(407) 936-0316
NPI assigned
Oct 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Authorized official

Name
Mrs. Judy Serafin
Title
Owner
Phone
(321) 439-4594

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X PT17963 FL Primary

Addresses

Primary practice location

956 International Pkwy Ste 1580
Lake Mary, FL 32746-5219

Mailing address

956 International Pkwy Ste 1580
Lake Mary, FL 32746-5219
Phone (407) 936-0314

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120425000137 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8921260704 Receives reassigned benefits from 3 practitioners
Practice locations: Lake Mary, FL

National Provider Directory

National Provider Directory

Locations

3577 Lake Emma Rd
Ste 121
Lake Mary, FL 32746
Phone (407) 333-2277

3577 Lake Emma Rd
Ste 109
Lake Mary, FL 32746
Phone (407) 936-0314

956 International Pkwy
Lake Mary, FL 32746
Phone (407) 936-0314

956 International Pkwy
#1580
Lake Mary, FL 32746
Phone (407) 706-1420

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680480000000",
    "number": "1437301025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "956 INTERNATIONAL PKWY STE 1580",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465219",
            "telephone_number": "407-936-0314",
            "fax_number": "407-936-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "956 INTERNATIONAL PKWY STE 1580",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465219",
            "telephone_number": "407-936-0314",
            "fax_number": "407-936-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISION PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-15",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A",
        "authorized_official_last_name": "SERAFIN",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-439-4594",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "PT17963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2023; 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.