Gustavo J. Medosky, L.M.T.

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA27822 Issued in FL

Practice address

205 SW 84TH Ave
Plantation, FL 33324-2708

Phone

(954) 536-0767

NPI assigned

Oct 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Medical Massage Inc

  • Massage Therapist
  • Davie, FL
  • NPI 1942499926
  NPD (past) Authorized official

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1578752549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6681 SW 20TH ST",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333175104",
            "telephone_number": "954-536-0767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 SW 84TH AVE",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242708",
            "telephone_number": "954-536-0767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 N Pine Island Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Plantation",
            "state": "FL",
            "postal_code": "333241849",
            "country_code": "US",
            "telephone_number": "954-476-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1912 S University Dr",
            "address_2": "B4",
            "address_purpose": "LOCATION",
            "city": "Davie",
            "state": "FL",
            "postal_code": "333245849",
            "country_code": "US",
            "telephone_number": "954-536-0767",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDOSKY",
        "first_name": "GUSTAVO",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "L.M.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-16",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA19949",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA27822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medikarma, Inc
• Yeney Medina Arencibia, BCBA, IBA, LBA (NC)
• Ashley Medina-Yntema, CCC-SLP
• Marisel Medina, D.P.M.
• Sarah Joyce Medley, MD
• Medwise LLC
• Medx Medical Center Inc.
• Meghan Victoria Meerbott, PHARMD
• Bonnie Lee Meere, R.N.F.A.
• Susan Marie Meese-Morris, RD, CSR, LDN

• Physical Therapy Assistant in Plantation, FL
• Providers in Plantation, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; 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.