Active NPI
Lucas Julio Proenca, PT
- Physical Therapist
- Miami, FL
National Provider Identifier
1760578082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT19743
- Practice address
- 800 NE 195TH St
Apt. 706
Miami, FL 33179-3414 - Phone
- (305) 653-9447
- Fax
- (305) 654-9263
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT19743 | FL | Primary |
Addresses
Primary practice location
800 NE 195TH St
Apt. 706
Miami, FL 33179-3414
Mailing address
800 NE 195TH St
Apt. 706
Miami, FL 33179-3414
Phone (305) 653-9447
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT19743 | Other | FL | PHYSICAL THERAPY LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT19743 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760578082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 NE 195TH ST",
"address_2": "APT. 706",
"city": "MIAMI",
"state": "FL",
"postal_code": "331793414",
"telephone_number": "305-653-9447",
"fax_number": "305-654-9263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 NE 195TH ST",
"address_2": "APT. 706",
"city": "MIAMI",
"state": "FL",
"postal_code": "331793414",
"telephone_number": "305-653-9447",
"fax_number": "305-654-9263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROENCA",
"first_name": "LUCAS",
"middle_name": "JULIO",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT19743",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPY LICENSE",
"identifier": "PT19743",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.