Active NPI
Dustin Clyde Tino, ATC, LAT, CSCS
- Athletic Trainer
- Fort Myers, FL
National Provider Identifier
1699946772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AL2363
- Practice address
- 5765 Trailwinds Dr
Unit 126
Fort Myers, FL 33907-7360 - Phone
- (507) 236-6728
- NPI assigned
- Mar 18, 2008
- Last updated
- Mar 18, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AL2363 | FL | Primary |
Addresses
Primary practice location
5765 Trailwinds Dr
Unit 126
Fort Myers, FL 33907-7360
Mailing address
5765 Trailwinds Dr
Unit 126
Fort Myers, FL 33907-7360
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 |
|---|---|---|---|
| AL2363 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205798400000",
"number": "1699946772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5765 TRAILWINDS DR",
"address_2": "UNIT 126",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339077360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5765 TRAILWINDS DR",
"address_2": "UNIT 126",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339077360",
"telephone_number": "507-236-6728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TINO",
"first_name": "DUSTIN",
"middle_name": "CLYDE",
"credential": "ATC, LAT, CSCS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-18",
"last_updated": "2008-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL2363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.