Individual provider Active NPI

Sergio Carrodeguas, DPT

  • Physical Therapist
  • Miami, FL
National Provider Identifier
1588310122
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT38392 Issued in FL
Practice address
2525 SW 75TH Ave
Miami, FL 33155-2800
Phone
(305) 262-6800
NPI assigned
Feb 22, 2022
Last updated
Feb 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT38392 FL Primary

Addresses

Primary practice location

2525 SW 75TH Ave
Miami, FL 33155-2800

Mailing address

4829 SW 163Rd PL
Miami, FL 33185-5120
Phone (786) 357-5118

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

NPI Registry JSON

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1588310122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4829 SW 163RD PL",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331855120",
            "telephone_number": "786-357-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 SW 75TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331552800",
            "telephone_number": "305-262-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRODEGUAS",
        "first_name": "SERGIO",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-22",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT38392",
            "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 Feb 22, 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.

Verify at the official NPI Registry.