Active NPI
Jovanni H Villadarez, M.D.
- Physical Therapist
- Port Charlotte, FL
National Provider Identifier
1770929978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT18746
- Practice address
- 4161 Tamiami TRL
Suite 104
Port Charlotte, FL 33952-9204 - Phone
- (941) 764-1933
- Fax
- (941) 764-1337
- NPI assigned
- May 14, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 | PT18746 | FL | Primary |
Addresses
Primary practice location
4161 Tamiami TRL
Suite 104
Port Charlotte, FL 33952-9204
Mailing address
4161 Tamiami TRL
Suite 104
Port Charlotte, FL 33952-9204
Phone (941) 764-1933
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT18746 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368489600000",
"number": "1770929978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4161 TAMIAMI TRL",
"address_2": "SUITE 104",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339529204",
"telephone_number": "941-764-1933",
"fax_number": "941-764-1337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4161 TAMIAMI TRL",
"address_2": "SUITE 104",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339529204",
"telephone_number": "941-764-1933",
"fax_number": "941-764-1337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLADAREZ",
"first_name": "JOVANNI",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-14",
"last_updated": "2013-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT18746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.