Active NPI
Mariana Talarico de Nolasco, PT
- Physical Therapist
- Hollywood, FL
National Provider Identifier
1548314578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 21718
- Practice address
- 3670 N 54TH Ave
Hollywood, FL 33021-2340 - Phone
- (305) 651-9311
- Fax
- (754) 201-1390
- NPI assigned
- Jan 23, 2007
- Last updated
- Jul 21, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 21718 | FL | Primary |
| Developmental Therapist | 222Q00000X | NU |
Addresses
Primary practice location
3670 N 54TH Ave
Hollywood, FL 33021-2340
Mailing address
3670 N 54TH Ave
Hollywood, FL 33021-2340
Phone (305) 651-9311
Other practice location 1
4620 Fillmore St
Hollywood, FL 33021-5814
Phone (305) 651-9311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891721300 | Medicaid | FL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 21718 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 123 Therapy Inc. | Current | Accepting new patients | |
| 123 Therapy Inc. | Physical Therapist | Current | Accepting new patients |
| 123 Special Care Kids Ppec LLC | Physical Therapist | Current | Accepting new patients |
Locations
14040 NW 7th Ave
Miami, FL 33168
Phone (305) 651-9311
Organizations & group practices 3
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.
-
- Physical Therapist
- Hollywood, FL
- NPI 1962086520
-
- Contractor
- Miami, FL
- NPI 1215801618
-
- Physical Therapist
- Hollywood, FL
- NPI 1538592977
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1548314578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3670 N 54TH AVE",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330212340",
"telephone_number": "305-651-9311",
"fax_number": "754-201-1390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3670 N 54TH AVE",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330212340",
"telephone_number": "305-651-9311",
"fax_number": "754-201-1390"
}
],
"practiceLocations": [
{
"address_1": "4620 Fillmore St",
"address_purpose": "LOCATION",
"city": "Hollywood",
"state": "FL",
"postal_code": "330215814",
"country_code": "US",
"telephone_number": "305-651-9311",
"fax_number": "754-201-1390",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TALARICO DE NOLASCO",
"first_name": "MARIANA",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-23",
"last_updated": "2022-07-21",
"certification_date": "2020-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT 21718",
"primary": true
},
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891721300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.