Individual provider Active NPI

Jorde Ruiz Tartabull

  • Physical Therapy Clinic/Center
  • Miami, FL
National Provider Identifier
1861624934
Registry record updated Aug 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
MA 48986 Issued in FL
Practice address
7171 Coral Way
Suite 400
Miami, FL 33155
Phone
(786) 970-5524
NPI assigned
Aug 21, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X
Physical Therapy Clinic/Center 261QP2000X MA 48986 FL Primary

Addresses

Primary practice location

7171 Coral Way
Suite 400
Miami, FL 33155

Mailing address

3211 W Flagler St
Apt PH
Miami, FL 33135
Phone (786) 970-5524

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

LicenseStateTypeSpecialty
MA 48986FLMDPhysical Therapy Clinic/Center

NPI Registry JSON

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

{
    "created_epoch": "1250812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250812800000",
    "number": "1861624934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3211 W FLAGLER ST",
            "address_2": "APT PH",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33135",
            "telephone_number": "786-970-5524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7171 CORAL WAY",
            "address_2": "SUITE 400",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33155",
            "telephone_number": "786-970-5524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARTABULL",
        "first_name": "JORDE",
        "middle_name": "RUIZ",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-21",
        "last_updated": "2009-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "MA 48986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.