Maxider Corporation

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

PT13467 Issued in FL

Legal business name

MAXIDER CORPORATION

Doing business as

Excell Rehab

Practice address

389 Commercial Court
Suite C
Venice, FL 34292

Phone

(941) 488-6600

NPI assigned

Mar 2, 2007

Last updated

Sep 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Pablo Edgardo DerboghossianNPI 1922158484

Title

President

Phone

(941) 488-6600

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• Excell Rehab Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Maxider Corporation

  dba On the Go Therapy

  • Physical Therapist
  • Sarasota, FL
  • NPI 1669501615

  O20040826000871

  Same enrollment

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Pablo Edgardo Der Boghossian, P.T.

  • Physical Therapist
  • Bradenton, FL
  • NPI 1922158484
  NPD (past) Authorized official
• Elvira M Carrillo, OTR

  • Occupational Therapist
  • Venice, FL
  • NPI 1912196528
  NPD (past)
• Ana Laura Mendez

  • Sports Physical Therapist
  • Venice, FL
  • NPI 1992855472

  Geriatrics

  NPD (past)
• Jessica Brelje, MPT

  • Physical Therapist
  • Morris, IL
  • NPI 1538296975
  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1780712539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "389 COMMERCIAL COURT",
            "address_2": "SUITE C",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "34292",
            "telephone_number": "941-488-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "389 COMMERCIAL COURT",
            "address_2": "SUITE C",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "34292",
            "telephone_number": "941-488-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIDER CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "DERBOGHOSSIAN",
        "authorized_official_first_name": "PABLO",
        "authorized_official_middle_name": "EDGARDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-488-6600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT13467",
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "FL",
            "license": "PT13467",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "FL",
            "license": "PT13467",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "FL",
            "license": "PT13467",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CG9065",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS NUMBER",
            "identifier": "Y903S",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NUMBER",
            "identifier": "7042130",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excell Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Matthews, MT-BC
• Victor Maulawin, PTA
• Cynthia S Maule, MD
• Alan Richard Maurer, M.D.
• Kacie Maurer, OTR
• Elisabeth Mayer, PMHNP
• Rebecca Mayper
• Sean Mazloom, MD
• Anne K. McBride, MD
• Joyce Ann McCaffrey, LDO

• Sports Physical Therapist in Venice, FL
• Providers in Venice, FL by specialty
• Sports Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.