Individual provider Active NPI

Oswaldo Rodriguez, PHYSICAL THERAPY ASS

  • Physical Therapy Assistant
  • Lake City, FL
National Provider Identifier
1760655682
Registry record updated Apr 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
00211 Issued in PR
Practice address
1229SW. Yorktown Glen
Lake City, FL 32025-0481
Phone
(386) 719-6975
NPI assigned
Apr 11, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2008

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 00211 PR Primary

Addresses

Primary practice location

1229SW. Yorktown Glen
Lake City, FL 32025-0481

Mailing address

1229SW Yorktown Glen
Lake City, FL 32025-0481

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
00211PRMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207872000000",
    "number": "1760655682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229SW YORKTOWN GLEN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320250481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229SW. YORKTOWN GLEN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320250481",
            "telephone_number": "386-719-6975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "OSWALDO",
        "credential": "PHYSICAL THERAPY ASS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-11",
        "last_updated": "2008-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PR",
            "license": "00211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2008; 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.