Active NPI
Terrence Blake
- Physical Therapy Assistant
- Miami, FL
National Provider Identifier
1710467105
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA19410
- Practice address
- 9400 SW 137TH Ave
Miami, FL 33186-1434 - Phone
- (786) 255-5137
- NPI assigned
- Aug 15, 2018
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA19410 | FL | Primary |
Addresses
Primary practice location
9400 SW 137TH Ave
Miami, FL 33186-1434
Mailing address
PO Box 970858
Miami, FL 33197-0858
Phone (305) 790-3463
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 |
|---|---|---|---|
| PTA19410 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534291200000",
"number": "1710467105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 970858",
"city": "MIAMI",
"state": "FL",
"postal_code": "331970858",
"telephone_number": "305-790-3463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9400 SW 137TH AVE",
"city": "MIAMI",
"state": "FL",
"postal_code": "331861434",
"telephone_number": "786-255-5137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKE",
"first_name": "TERRENCE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-15",
"last_updated": "2018-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "PTA19410",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.