Active NPI
Andres Correa-Vega
- Physical Therapy Assistant
- Orlando, FL
National Provider Identifier
1851901169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA30303
- Practice address
- 6900 Tavistock Lakes Blvd Ste 400
Orlando, FL 32827-7593 - Phone
- (407) 970-0824
- Fax
- (321) 235-5506
- NPI assigned
- Aug 3, 2020
- 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 Therapy Assistant | 225200000X | PTA30303 | FL | Primary |
Addresses
Primary practice location
6900 Tavistock Lakes Blvd Ste 400
Orlando, FL 32827-7593
Mailing address
1545 Oakwood CT
Apopka, FL 32703-1579
Phone (321) 900-5391
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 |
|---|---|---|---|
| PTA30303 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596672000000",
"number": "1851901169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1545 OAKWOOD CT",
"city": "APOPKA",
"state": "FL",
"postal_code": "327031579",
"telephone_number": "321-900-5391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6900 TAVISTOCK LAKES BLVD STE 400",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328277593",
"telephone_number": "407-970-0824",
"fax_number": "321-235-5506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORREA-VEGA",
"first_name": "ANDRES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-08-03",
"last_updated": "2020-08-06",
"certification_date": "2020-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "PTA30303",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.