Individual provider Active NPI

Leslie Marsicano

  • Physical Therapy Assistant
  • Bradenton, FL
National Provider Identifier
1629205091
Registry record updated Jun 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA 0001237 Issued in FL
Practice address
5612 26TH St W
Bradenton, FL 34207-3515
Phone
(941) 751-6532
Fax
(941) 751-6932
NPI assigned
Jun 12, 2009
Last updated
Jun 12, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA 0001237 FL Primary

Addresses

Primary practice location

5612 26TH St W
Bradenton, FL 34207-3515

Mailing address

8800 Grand Oak Cir
Suite 450
Tampa, FL 33637-2006
Phone (813) 558-6548

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

LicenseStateTypeSpecialty
PTA 0001237FLMDPhysical Therapy Assistant

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244764800000",
    "number": "1629205091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8800 GRAND OAK CIR",
            "address_2": "SUITE 450",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336372006",
            "telephone_number": "813-558-6548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5612 26TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342073515",
            "telephone_number": "941-751-6532",
            "fax_number": "941-751-6932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSICANO",
        "first_name": "LESLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-12",
        "last_updated": "2009-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 0001237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2009; 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.