Active NPI
Joseph Mistretta
- Athletic Trainer
- Seffner, FL
National Provider Identifier
1619350600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AL 4167
- Practice address
- 11605 E US Highway 92
Seffner, FL 33584-3305 - Phone
- (607) 237-8773
- NPI assigned
- Jul 8, 2015
- Last updated
- Jul 8, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AL 4167 | FL | Primary |
Addresses
Primary practice location
11605 E US Highway 92
Seffner, FL 33584-3305
Mailing address
4809 N Armenia Ave
200
Tampa, FL 33603-1447
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 |
|---|---|---|---|
| AL 4167 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436313600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436313600000",
"number": "1619350600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4809 N ARMENIA AVE",
"address_2": "200",
"city": "TAMPA",
"state": "FL",
"postal_code": "336031447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11605 E US HIGHWAY 92",
"city": "SEFFNER",
"state": "FL",
"postal_code": "335843305",
"telephone_number": "607-237-8773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MISTRETTA",
"first_name": "JOSEPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-08",
"last_updated": "2015-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL 4167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seffner, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.