Active NPI
Reymon Lobos De Real
- Physical Therapist
- Fort Lauderdale, FL
National Provider Identifier
1811571508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 25102
- Practice address
- 2831 N Ocean Blvd Apt 408N
Fort Lauderdale, FL 33308-7583 - Phone
- (305) 812-1427
- NPI assigned
- May 8, 2021
- Last updated
- May 8, 2021
- 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 | 25102 | FL | Primary |
Addresses
Primary practice location
2831 N Ocean Blvd Apt 408N
Fort Lauderdale, FL 33308-7583
Mailing address
2831 N Ocean Blvd Apt 408N
Fort Lauderdale, FL 33308-7583
Phone (305) 812-1427
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 |
|---|---|---|---|
| 25102 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620432000000",
"number": "1811571508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2831 N OCEAN BLVD APT 408N",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333087583",
"telephone_number": "305-812-1427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2831 N OCEAN BLVD APT 408N",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333087583",
"telephone_number": "305-812-1427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE REAL",
"first_name": "REYMON",
"middle_name": "LOBOS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-05-08",
"last_updated": "2021-05-08",
"certification_date": "2021-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "25102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.