Leodelyn A Mata

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

31271 Issued in FL

Practice address

3788 Saltmarsh Loop
Sanford, FL 32773-7092

Phone

(217) 691-3561

NPI assigned

Nov 4, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sobe Innovative Rehabilitation PLLC

  • Physical Therapist
  • Miami, FL
  • NPI 1164800595
  Medicare reassignment NPD

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

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1518780907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3788 SALTMARSH LOOP",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327737092",
            "telephone_number": "217-691-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3788 SALTMARSH LOOP",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327737092",
            "telephone_number": "217-691-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATA",
        "first_name": "LEODELYN",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "31271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krystle Martin, MA
• Krystle Martin
• Yolanda Martin, PTA
• Raul Martinez
• Thomas Robert Martony, D.P.T.
• Manu Thomas Mathew
• Alice Johanie Matias, MD
• Ashley Rose Matos
• Michele May Matteini
• Matthew C Demetree DC, PA

• Physical Therapist in Sanford, FL
• Providers in Sanford, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.