Rivazzelly Bastardo, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA30057 Issued in FL

Practice address

900 W 49TH St Ste 332
Hialeah, FL 33012-3489

Phone

(786) 879-5303

NPI assigned

Feb 24, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1770117202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18965 NW 62ND AVE APT 212",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330155057",
            "telephone_number": "786-901-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W 49TH ST STE 332",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330123489",
            "telephone_number": "786-879-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTARDO",
        "first_name": "RIVAZZELLY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-24",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA30057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Clinicsource.com",
            "affiliation": "N",
            "address_1": "900 W 49th St Ste 332",
            "city": "Hialeah",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330123489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lazaro Basart
• Ghaith Adeeb Bashour, LDO
• Basic Treatment Center Corp
• Basil M Yates MD PA
• Yamilda Bassols-Porro
• Gabriela Baster
• Daylis Basulto Romero
• Katya Guadalupe Basulto Sanchez
• Janisset Basulto, FNP, APRN
• Lourdes Basulto, D.A

• Physical Therapy Assistant in Hialeah, FL
• Providers in Hialeah, 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 Feb 24, 2020; 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.