Prodigy Healthcare Specialists, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT11333 Issued in FL

Legal business name

PRODIGY HEALTHCARE SPECIALISTS, INC.

Practice address

2823 US Highway 301 N
Ste. 4
Ellenton, FL 34222-2084

Phone

(941) 729-8600

Fax

(941) 729-4440

NPI assigned

Feb 15, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Rachel K Relao, RPTNPI 1013118926

Title

Physical Therapist

Phone

(941) 729-8600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Prodigy Physical Therapy Doing business as

Locations

Practitioners 2

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

• Rachel Relao, RPT

  • Physical Therapist
  • Ellenton, FL
  • NPI 1013118926
  NPD (past) Authorized official
• Conseulo Villareal, RPT

  • Physical Therapist
  • Ellenton, FL
  • NPI 1952502874
  NPD (past)

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497898688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2823 US HIGHWAY 301 N",
            "address_2": "STE. 4",
            "city": "ELLENTON",
            "state": "FL",
            "postal_code": "342222084",
            "telephone_number": "941-729-8600",
            "fax_number": "941-729-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2823 US HIGHWAY 301 N",
            "address_2": "STE. 4",
            "city": "ELLENTON",
            "state": "FL",
            "postal_code": "342222084",
            "telephone_number": "941-729-8600",
            "fax_number": "941-729-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGY HEALTHCARE SPECIALISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RELAO",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "941-729-8600",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "PT11333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "Y905G",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prodigy Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erica Pickle
• Erin Porter, LCSW
• Lan Potter, NURSE PRACTITIONER
• Premier Family Chiropractic, LLC
• Primehealth Urgent Care LLC
• Rachel Relao, RPT
• Curtis Matthew Reynolds, D.C.
• Cesar Augusto Roman, M.A.
• Jazmine Rosario Alviarez
• Jeremiah S Rosenkrans, D.P.T

• Physical Therapy Clinic/Center in Ellenton, FL
• Providers in Ellenton, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.