Active NPI
Antonino Serrano Mendejar II, RPT
- Physical Therapist
- Sunrise, FL
National Provider Identifier
1851781819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4399
- Practice address
- 1580 Sawgrass Corporate Pkwy Ste 100
Sunrise, FL 33323-2860 - Phone
- (954) 332-4445
- Fax
- (866) 422-6431
- NPI assigned
- Jan 29, 2015
- 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 | 4399 | NM | Primary |
Addresses
Primary practice location
1580 Sawgrass Corporate Pkwy Ste 100
Sunrise, FL 33323-2860
Mailing address
1580 Sawgrass Corporate Pkwy Ste 100
Sunrise, FL 33323-2860
Phone (954) 332-4445
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4399 | NM | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medpro Healthcare Staffing | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rehabilitation Hospital
- Sunrise, FL
- NPI 1922342021
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422489600000",
"number": "1851781819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1580 SAWGRASS CORPORATE PKWY STE 100",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333232860",
"telephone_number": "954-332-4445",
"fax_number": "866-422-6431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1580 SAWGRASS CORPORATE PKWY STE 100",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333232860",
"telephone_number": "954-332-4445",
"fax_number": "866-422-6431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDEJAR",
"first_name": "ANTONINO",
"middle_name": "SERRANO",
"name_prefix": "Mr.",
"name_suffix": "II",
"credential": "RPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-01-29",
"last_updated": "2015-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "4399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunrise, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.