Individual provider Active NPI

Dominga Antonia Polo-Palmer, RPT

  • Geriatric Physical Therapist
  • Fort Lauderdale, FL
National Provider Identifier
1720275902
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
PT15461 Issued in FL
Practice address
1950 SW 37TH Ave
Fort Lauderdale, FL 33312-4220
Phone
(954) 581-5492
NPI assigned
Oct 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X PT15461 FL Primary

Addresses

Primary practice location

1950 SW 37TH Ave
Fort Lauderdale, FL 33312-4220

Mailing address

1950 SW 37TH Ave
Fort Lauderdale, FL 33312-4220
Phone (954) 581-5492

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dominga'S Therapy Services PTR PA Past Accepting new patients
Dominga'S Therapy Services PTR. PA. Geriatrics Past Accepting new patients
Palm Beach Therapy Inc. PastSince Sep 30, 2004 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1720275902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 SW 37TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333124220",
            "telephone_number": "954-581-5492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 SW 37TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333124220",
            "telephone_number": "954-581-5492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLO-PALMER",
        "first_name": "DOMINGA",
        "middle_name": "ANTONIA",
        "name_prefix": "Mrs.",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "FL",
            "license": "PT15461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; 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.