Individual provider Active NPI

Lorena Fernandez-Moran, PTA

  • Physical Therapy Assistant
  • Coral Gables, FL
National Provider Identifier
1871191130
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA29269 Issued in FL
Practice address
420 S Dixie Hwy Ste 4D
Coral Gables, FL 33146-2232
Phone
(305) 856-9000
NPI assigned
Oct 9, 2020
Last updated
Oct 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 225200000X PTA29269 FL Primary

Addresses

Primary practice location

420 S Dixie Hwy Ste 4D
Coral Gables, FL 33146-2232

Mailing address

420 S Dixie Hwy Ste 4D
Coral Gables, FL 33146-2232

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
PTA29269FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Reaction Rehab, LLC CurrentSince Oct 11, 2020 Accepting new patients
Rehabilitation Center of Miami LLC Single Specialty CurrentSince Oct 11, 2020 Accepting new patients

Locations

420 S Dixie Hwy
Ste 4D
Coral Gables, FL 33146
Phone (305) 568-9000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1871191130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 S DIXIE HWY STE 4D",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S DIXIE HWY STE 4D",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462232",
            "telephone_number": "305-856-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ-MORAN",
        "first_name": "LORENA",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA29269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.

Verify at the official NPI Registry.