Active NPI
Manuel Socorro, LMT
- Physical Therapy Assistant
- Miami, FL
National Provider Identifier
1629328174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA29361
- Practice address
- 9626 SW 146TH Ave
Miami, FL 33186-6917 - Phone
- (786) 715-3516
- NPI assigned
- Sep 12, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA64134 | FL | |
| Physical Therapy Assistant | 225200000X | PTA29361 | FL | Primary |
Addresses
Primary practice location
9626 SW 146TH Ave
Miami, FL 33186-6917
Mailing address
9626 SW 146TH Ave
Miami, FL 33186-6917
Phone (786) 715-3516
Other practice location 1
7388 SW 152nd Ave
Miami, FL 33193-2389
Phone (786) 715-3516
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 |
|---|---|---|---|
| PTA29361 | FL | MD | Physical Therapy Assistant |
| MA64134 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573516800000",
"number": "1629328174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9626 SW 146TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331866917",
"telephone_number": "786-715-3516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9626 SW 146TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331866917",
"telephone_number": "786-715-3516"
}
],
"practiceLocations": [
{
"address_1": "7388 SW 152nd Ave",
"address_purpose": "LOCATION",
"city": "Miami",
"state": "FL",
"postal_code": "331932389",
"country_code": "US",
"telephone_number": "786-715-3516",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SOCORRO",
"first_name": "MANUEL",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-09-12",
"last_updated": "2019-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA64134",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "PTA29361",
"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 Nov 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.