Individual provider Active NPI

Clarice Christabel Alphonso

  • Physical Therapist
  • Cape Coral, FL
National Provider Identifier
1629490339
Registry record updated Mar 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT28862 Issued in FL
Practice address
216 Santa Barbara Blvd
Cape Coral, FL 33991-2031
Phone
(408) 594-8753
NPI assigned
Jan 15, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2015

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 PT28862 FL Primary

Addresses

Primary practice location

216 Santa Barbara Blvd
Cape Coral, FL 33991-2031

Mailing address

1210 SE 6TH Ter Apt 86
Cape Coral, FL 33990-2912
Phone (408) 594-8753

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
PT28862FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425945600000",
    "number": "1629490339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 SE 6TH TER APT 86",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339902912",
            "telephone_number": "408-594-8753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 SANTA BARBARA BLVD",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339912031",
            "telephone_number": "408-594-8753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALPHONSO",
        "first_name": "CLARICE",
        "middle_name": "CHRISTABEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-15",
        "last_updated": "2015-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT28862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.

Verify at the official NPI Registry.