Individual provider Active NPI

Liliana P Defiore, RPT

  • Physical Therapist
  • Fort Myers, FL
National Provider Identifier
1861460024
Registry record updated Dec 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4968 Royal Gulf Cir
Fort Myers, FL 33966-7006
Phone
(239) 275-4411
Fax
(239) 275-6408
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

4968 Royal Gulf Cir
Fort Myers, FL 33966-7006

Mailing address

4968 Royal Gulf Cir
Fort Myers, FL 33966-7006
Phone (239) 275-4411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041013000886 FL Practitioner - Physical Therapist in Private Practice 0143280255 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Edge Physical Therapy Physical Therapist CurrentSince Sep 10, 2024 Accepting new patients
Edge Diagnostics PastSince Feb 2, 2025 Accepting new patients

Locations

10591 Veneto Dr
Fort Myers, FL 33913
Phone (239) 244-3835

3300 Herons Glen Blvd
North Ft Myers, FL 33917
Phone (239) 244-3835

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417478400000",
    "number": "1861460024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4968 ROYAL GULF CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339667006",
            "telephone_number": "239-275-4411",
            "fax_number": "239-275-6408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4968 ROYAL GULF CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339667006",
            "telephone_number": "239-275-4411",
            "fax_number": "239-275-6408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFIORE",
        "first_name": "LILIANA",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2014-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; 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.