Active NPI
Alan Atogamis De Souza, PT
- Physical Therapist
- Orlando, FL
National Provider Identifier
1437764313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT39673
- Practice address
- 500 N Semoran Blvd Ste 101
Orlando, FL 32807-3381 - Phone
- (407) 815-6555
- NPI assigned
- Sep 9, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT012759 | GA | |
| Physical Therapist | 225100000X | PT39673 | FL | Primary |
Addresses
Primary practice location
500 N Semoran Blvd Ste 101
Orlando, FL 32807-3381
Mailing address
1656 Wilkinson Way SE
Smyrna, GA 30080-1604
Phone (206) 566-1078
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA99739 | Other | FL | MEDICAL LICENSE |
| PT39673 | Other | FL | MEDICAL LICENSE |
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 |
|---|---|---|---|
| PT39673 | FL | MD | Physical Therapist |
| MT012759 | GA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MD Total Health Centers Inc | Physical Therapist | Current | Accepting new patients |
| Physical Therapy Now Holdings, LLC | Physical Therapist | Past | Accepting new patients |
Locations
500 N Semoran Blvd
Ste 101
Orlando, FL 32807
Phone (407) 815-6555
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671667200000",
"number": "1437764313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1656 WILKINSON WAY SE",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300801604",
"telephone_number": "206-566-1078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 N SEMORAN BLVD STE 101",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328073381",
"telephone_number": "407-815-6555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE SOUZA",
"first_name": "ALAN",
"middle_name": "ATOGAMIS",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-09-09",
"last_updated": "2022-12-22",
"certification_date": "2022-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "GA",
"license": "MT012759",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT39673",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "MA99739",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "PT39673",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.