Individual provider Active NPI

Gustavo Adolfo Bobadilla, OTR/L

  • Occupational Therapist
  • Coral Gables, FL
National Provider Identifier
1467701029
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT15063 Issued in FL
Practice address
120 Santander Ave
Coral Gables, FL 33134
Phone
(305) 878-0978
NPI assigned
Aug 29, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT15063 FL Primary

Addresses

Primary practice location

120 Santander Ave
Coral Gables, FL 33134

Mailing address

120 Santander Ave
Coral Gables, FL 33134
Phone (305) 878-0978

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

LicenseStateTypeSpecialty
OT15063FLMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1467701029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 SANTANDER AVE",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "33134",
            "telephone_number": "305-878-0978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SANTANDER AVE",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "33134",
            "telephone_number": "305-878-0978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOBADILLA",
        "first_name": "GUSTAVO",
        "middle_name": "ADOLFO",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT15063",
            "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 Aug 29, 2012; 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.