Individual provider Active NPI

Eduardo Sotolongo Perez, PTA

  • Physical Therapy Assistant
  • Boca Raton, FL
National Provider Identifier
1720445901
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA26293 Issued in FL
Practice address
5520 Pacific Blvd Apt 204
Boca Raton, FL 33433-6788
Phone
(786) 506-1152
NPI assigned
Jan 19, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA26293 FL Primary

Addresses

Primary practice location

5520 Pacific Blvd Apt 204
Boca Raton, FL 33433-6788

Mailing address

5520 Pacific Blvd Apt 204
Boca Raton, FL 33433-6788
Phone (786) 506-1152

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
PTA26293FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1720445901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5520 PACIFIC BLVD APT 204",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334336788",
            "telephone_number": "786-506-1152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 PACIFIC BLVD APT 204",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334336788",
            "telephone_number": "786-506-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTOLONGO PEREZ",
        "first_name": "EDUARDO",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-19",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA26293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; 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.