Individual provider Active NPI

Laura Fernanda Castroviejo

  • Physical Therapist
  • Miami, FL
National Provider Identifier
1619216561
Registry record updated Feb 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT20858 Issued in FL
Practice address
13349 SW 122ND Ave
Miami, FL 33186-6544
Phone
(786) 201-1703
Fax
(786) 573-3619
NPI assigned
Feb 12, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2013

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 PT20858 FL Primary

Addresses

Primary practice location

13349 SW 122ND Ave
Miami, FL 33186-6544

Mailing address

13349 SW 122ND Ave
Miami, FL 33186-6544
Phone (786) 201-1703

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130624000443 FL Practitioner - Physical Therapist in Private Practice 3678712650 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT20858FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Valles & Associates Rehabilitation Services Inc CurrentSince Apr 1, 2022 Accepting new patients
Valles & Associates Rehabilitation Services Inc CurrentSince Apr 1, 2022 Accepting new patients
Kinetic Rehab Inc Physical Therapist CurrentSince Feb 19, 2013 Accepting new patients

Locations

12600 SW 120th St
Ste 109
Miami, FL 33186
Phone (305) 233-7035

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1360627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360627200000",
    "number": "1619216561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13349 SW 122ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331866544",
            "telephone_number": "786-201-1703",
            "fax_number": "786-573-3619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13349 SW 122ND AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331866544",
            "telephone_number": "786-201-1703",
            "fax_number": "786-573-3619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTROVIEJO",
        "first_name": "LAURA",
        "middle_name": "FERNANDA",
        "name_prefix": "Prof.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-12",
        "last_updated": "2013-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT20858",
            "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 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.