Patricia Custodio, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA29763 Issued in FL

Practice address

2090 Palm Beach Lakes Blvd Ste 900
West Palm Beach, FL 33409-6508

Phone

(561) 335-5965

NPI assigned

Nov 3, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1572739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572739200000",
    "number": "1710521786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 BENT TREE DR",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334183598",
            "telephone_number": "631-495-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 PALM BEACH LAKES BLVD STE 900",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096508",
            "telephone_number": "561-335-5965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSTODIO",
        "first_name": "PATRICIA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-03",
        "last_updated": "2019-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA29763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald R Curl, D.D.S.
• Currie Inpatient Physicians
• Chad Matthew Curtis
• Glauco Cusciano, MS
• Laura Cusco
• Customized Care Management Services, LLC
• Christopher Peter Cutaia
• Nora L. Cutillar, M.D.
• Cutting Edge Physical Therapy & Wellness
• Cyberknife Center of Palm Beach LLC

• Physical Therapy Assistant in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2019; 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.