Individual provider Active NPI

Reynaldo Gonzales Morales III, PT

  • Physical Therapist
  • Fort Lauderdale, FL
National Provider Identifier
1497049902
Registry record updated Jun 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
008893 Issued in CT
Practice address
3201 W Commercial Blvd
Suite 116
Fort Lauderdale, FL 33309-3440
Phone
(954) 632-5970
NPI assigned
Jun 1, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 008893 CT Primary

Addresses

Primary practice location

3201 W Commercial Blvd
Suite 116
Fort Lauderdale, FL 33309-3440

Mailing address

3201 W Commercial Blvd
Suite 116
Fort Lauderdale, FL 33309-3440
Phone (954) 632-5970

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
008893CTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Medpro Physical Therapist Past Accepting new patients
Prohealth Physicians PC Physical Therapist Past Accepting new patients

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": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306886400000",
    "number": "1497049902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 W COMMERCIAL BLVD",
            "address_2": "SUITE 116",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093440",
            "telephone_number": "954-632-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 W COMMERCIAL BLVD",
            "address_2": "SUITE 116",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093440",
            "telephone_number": "954-632-5970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "REYNALDO",
        "middle_name": "GONZALES",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-01",
        "last_updated": "2011-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "008893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; 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.