NPIMap

Organization Active NPI

Coral Gables Physical Therapy, L.L.C.

  • Physical Therapy Clinic/Center
  • Coral Gables, FL
National Provider Identifier
1467060939
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
CORAL GABLES PHYSICAL THERAPY, L.L.C.
Practice address
4110 Aurora St
Coral Gables, FL 33146-1416
Phone
(305) 722-0568
Fax
(305) 446-1565
NPI assigned
Jul 21, 2020
Last updated
Jul 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Authorized official

Name
Mr. Ronald Yacoub, MSPTNPI 1174642110
Title
Owner
Phone
(305) 722-0568

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

4110 Aurora St
Coral Gables, FL 33146-1416

Mailing address

PO Box 331912
Miami, FL 33233-1912
Phone (305) 722-0568

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201029001534 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2668882804 Receives reassigned benefits from 14 practitioners
Practice locations: Coral Gables, FL

National Provider Directory

National Provider Directory

Locations

4110 Aurora St
Coral Gables, FL 33146
Phone (305) 218-8929

4200 Laguna St
Coral Gables, FL 33146
Phone (305) 441-5258

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1467060939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 331912",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "332331912",
            "telephone_number": "305-722-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 AURORA ST",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331461416",
            "telephone_number": "305-722-0568",
            "fax_number": "305-446-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAL GABLES PHYSICAL THERAPY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-21",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "YACOUB",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-722-0568",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.