Ethan O'Hearn, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA29120 Issued in FL

Practice address

1586 Bloomingdale Ave
Valrico, FL 33596-6101

Phone

(813) 978-9700

Fax

(813) 558-6001

NPI assigned

Jul 26, 2024

Sex

Male

Sole proprietor

Yes

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": "1721952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1740018019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13020 N TELECOM PKWY",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370915",
            "telephone_number": "813-978-9700",
            "fax_number": "813-558-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1586 BLOOMINGDALE AVE",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335966101",
            "telephone_number": "813-978-9700",
            "fax_number": "813-558-6001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13020 N Telecom Pkwy",
            "address_purpose": "LOCATION",
            "city": "Temple Terrace",
            "state": "FL",
            "postal_code": "336370915",
            "country_code": "US",
            "telephone_number": "813-978-9700 x7650",
            "fax_number": "813-558-6001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'HEARN",
        "first_name": "ETHAN",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-26",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA29120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julianne North
• Martin Northrop
• Erica Lynn Novatka, APRN
• Emily Paige Mitchell O'Brien, MA, CCC-SLP
• Mary Ellen O'Brien, SLP-A
• Kevin Reinier Ochoa Casas, M.S., BCBA
• Cynthia Odukomaiya
• Emmy J. Olson, B.A./SLP-A
• Elsie Aimee Orellano Laureano, PH.D.,RDN,LMT,CSOWM
• Ismael Ortiz Jr., PTA

• Physical Therapy Assistant in Valrico, FL
• Providers in Valrico, 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 Jul 26, 2024; 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.