Active NPI
Jusette Espulgar Ticzon
- Physical Therapist
- Coral Springs, FL
National Provider Identifier
1619338092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 61546
- Practice address
- 5900 W Sample Rd
Apt. 304
Coral Springs, FL 33067-3248 - Phone
- (954) 234-4847
- Fax
- (954) 942-1130
- NPI assigned
- Mar 14, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 61546 | OR | Primary |
Addresses
Primary practice location
5900 W Sample Rd
Apt. 304
Coral Springs, FL 33067-3248
Mailing address
5900 W Sample Rd
Apt. 304
Coral Springs, FL 33067-3248
Phone (954) 234-4847
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
| License | State | Type | Specialty |
|---|---|---|---|
| 61546 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458086400000",
"number": "1619338092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5900 W SAMPLE RD",
"address_2": "APT. 304",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330673248",
"telephone_number": "954-234-4847",
"fax_number": "954-942-1130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 W SAMPLE RD",
"address_2": "APT. 304",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330673248",
"telephone_number": "954-234-4847",
"fax_number": "954-942-1130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TICZON",
"first_name": "JUSETTE",
"middle_name": "ESPULGAR",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-14",
"last_updated": "2016-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "61546",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coral Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.