Active NPI
Zenobia Carmen Montero Mendoza
- Geriatric Physical Therapist
- Lake Park, FL
National Provider Identifier
1689447807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- PTA23077
- Practice address
- 640 Palmetto Dr
Lake Park, FL 33403-2220 - Phone
- (954) 261-5485
- NPI assigned
- Oct 31, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | PTA23077 | FL | Primary |
Addresses
Primary practice location
640 Palmetto Dr
Lake Park, FL 33403-2220
Mailing address
640 Palmetto Dr
Lake Park, FL 33403-2220
Phone (954) 261-5485
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 |
|---|---|---|---|
| PTA23077 | FL | MD | Geriatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698710400000",
"number": "1689447807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "640 PALMETTO DR",
"city": "LAKE PARK",
"state": "FL",
"postal_code": "334032220",
"telephone_number": "954-261-5485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 PALMETTO DR",
"city": "LAKE PARK",
"state": "FL",
"postal_code": "334032220",
"telephone_number": "954-261-5485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONTERO MENDOZA",
"first_name": "ZENOBIA",
"middle_name": "CARMEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-10-31",
"last_updated": "2023-10-31",
"certification_date": "2023-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "FL",
"license": "PTA23077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.