Jonathan Keith Boone

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT34137 Issued in FL

Practice address

7500 SW 30TH St
Davie, FL 33314-1020

Phone

(954) 452-7012

NPI assigned

Dec 18, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598140800000",
    "number": "1538675210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2741 OCEAN CLUB BLVD APT 107",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330193935",
            "telephone_number": "302-222-8726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 SW 30TH ST",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333141020",
            "telephone_number": "954-452-7012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "412 Malcolm Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "MD",
            "postal_code": "211576174",
            "country_code": "US",
            "telephone_number": "410-751-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOONE",
        "first_name": "JONATHAN",
        "middle_name": "KEITH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-18",
        "last_updated": "2020-08-23",
        "certification_date": "2020-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "FL",
            "license": "PT34137",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT34137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley M Bonilla
• Carmen Bonilla
• Rosanna Bonilla
• Brianna Yogita Boodhoo
• Janelle M Booker, M.S., BCBA
• Katelyn Jae Boone
• Jessica Booth
• Nislievy M Borges Tortolo
• Deanna Born, O.D.
• Joseph A Bornstein, MSN, APRN, FNP-BC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.