Individual provider Active NPI

Rosa M. Roman Gonzalez, OT

  • Pediatric Occupational Therapist
  • Lake Worth, FL
National Provider Identifier
1710134838
Registry record updated Aug 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT 13282 Issued in FL
Practice address
6164 Willoughby Cir
Lake Worth, FL 33463-9308
Phone
(732) 896-8373
NPI assigned
Aug 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT 13282 FL Primary

Addresses

Primary practice location

6164 Willoughby Cir
Lake Worth, FL 33463-9308

Mailing address

6164 Willoughby Cir
Lake Worth, FL 33463-9308
Phone (732) 896-8373

Other names 1

  • Rosa M Serrano Professional name

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
OT 13282FLMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219190400000",
    "number": "1710134838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6164 WILLOUGHBY CIR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334639308",
            "telephone_number": "732-896-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6164 WILLOUGHBY CIR",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334639308",
            "telephone_number": "732-896-8373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMAN GONZALEZ",
        "first_name": "ROSA",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-20",
        "last_updated": "2008-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT 13282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSA",
            "last_name": "SERRANO",
            "middle_name": "M",
            "credential": "OT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.

Verify at the official NPI Registry.