Enya Fernandez Pudpud

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT12371 Issued in FL

Practice address

7734 Watermark LN
Jacksonville, FL 32256-4111

Phone

(904) 891-9932

NPI assigned

Sep 18, 2023

Last updated

Sep 18, 2023By the provider in NPPES

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

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthpro Heritage Rehab and Fitness LLCGroup PAC ID 6507832573, 976 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Coral Gables, FL
  • NPI 1871972653
  Medicare reassignment Care Compare group NPD
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Independence, MO
  • NPI 1871072462
  NPD

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1710765227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7734 WATERMARK LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322564111",
            "telephone_number": "904-891-9932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7734 WATERMARK LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322564111",
            "telephone_number": "904-891-9932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUDPUD",
        "first_name": "ENYA",
        "middle_name": "FERNANDEZ",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT12371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Publix Super Markets, Inc. (Publix Pharmacy #2103)
• Publix Super Markets, Inc. (Publix Pharmacy #1468)
• Brett Christopher Puckett, MD
• Todd Trabor Puckett, D.M.D.
• Puddle of Hearts Homecare LLC
• Romelia Puel, RPH
• Nesert Ellaine Puenary, ASSOCIATE IN SCIENCE
• Eric Charles Puestow, MD
• Ideal Pugh
• Keisha D Pugh, APRN

• Physical Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.