Individual provider Active NPI

Ruben Gonzalez Jr., PTA

  • Physical Therapy Assistant
  • Miami, FL
National Provider Identifier
1538877295
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA32432 Issued in FL
Practice address
12548 SW 8TH St
Miami, FL 33184-1412
Phone
(786) 453-3727
Fax
(786) 693-8265
NPI assigned
Nov 11, 2022
Last updated
May 31, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA32432 FL Primary

Addresses

Primary practice location

12548 SW 8TH St
Miami, FL 33184-1412

Mailing address

12420 SW 188TH Ter
Miami, FL 33177-3148
Phone (305) 457-0444

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTA32432FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prosper Medical Office Corp. Physical Therapy Assistant CurrentSince Sep 19, 2024 Accepting new patients
Doctor's Medical Group, Inc CurrentSince Nov 13, 2022 Accepting new patients

Locations

12548 SW 8th St
Miami, FL 33184
Phone (786) 453-3727

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1668124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1538877295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12420 SW 188TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331773148",
            "telephone_number": "305-457-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12548 SW 8TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331841412",
            "telephone_number": "786-453-3727",
            "fax_number": "786-693-8265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "RUBEN",
        "name_suffix": "Jr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-11",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA32432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; 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.