Individual provider Active NPI

John J Zuluaga, ATC

  • Athletic Trainer
  • Pompano Beach, FL
National Provider Identifier
1659006658
Registry record updated Sep 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AL4309 Issued in FL
Practice address
1040 Lyons Park Dr
Pompano Beach, FL 33060-8765
Phone
(786) 348-4162
NPI assigned
Jul 22, 2022
Last updated
Sep 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic TrainerGroup: 193400000X SINGLE SPECIALTY GROUP 2255A2300X AL4309 FL Primary

Addresses

Primary practice location

1040 Lyons Park Dr
Pompano Beach, FL 33060-8765

Mailing address

1040 Lyons Park Dr
Pompano Beach, FL 33060-8765
Phone (786) 348-4162

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
AL4309FLMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662163200000",
    "number": "1659006658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 LYONS PARK DR",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330608765",
            "telephone_number": "786-348-4162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 LYONS PARK DR",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330608765",
            "telephone_number": "786-348-4162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZULUAGA",
        "first_name": "JOHN",
        "middle_name": "J",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-22",
        "last_updated": "2022-09-03",
        "certification_date": "2022-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL4309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2022; 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.