Maxwellness Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT20304 Issued in FL

Legal business name

MAXWELLNESS PHYSICAL THERAPY LLC

Practice address

18600 NW 87TH Ave Unit 126
Hialeah, FL 33015-3536

Phone

(954) 869-4310

Fax

(954) 869-4313

NPI assigned

Jan 20, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Jean Pascal Pradel, PTNPI 1609965227

Title

Physical Therapy Director

Phone

(954) 558-3462

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Maxwellness Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Maxwellness Physical Therapy

  • Physical Therapist
  • Hialeah, FL
  • NPI 1417350588
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jean Pascal Pradel, RPT.

  • Physical Therapist
  • Hialeah, FL
  • NPI 1609965227
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1421712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595203200000",
    "number": "1881083475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18600 NW 87TH AVE UNIT 126",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330153536",
            "telephone_number": "954-869-4310",
            "fax_number": "954-869-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18600 NW 87TH AVE UNIT 126",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330153536",
            "telephone_number": "954-869-4310",
            "fax_number": "954-869-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXWELLNESS PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-20",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A",
        "authorized_official_last_name": "PRADEL",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "PASCAL",
        "authorized_official_title_or_position": "PHYSICAL THERAPY DIRECTOR",
        "authorized_official_telephone_number": "954-558-3462",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "PT20304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PT20304",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890766800",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "miramar@physicaltherapynow.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "miramar@physicaltherapynow.com",
            "address_1": "18600 NW 87th Ave Unit 126",
            "city": "Hialeah",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330153536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Max Pharmacy Corp
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• Max Rehabilitation Center,Inc
• Maxlife Medical Center Inc
• Maxwellness Physical Therapy
• Joel Maya Herrera
• Maya Home Health Care Corp.
• Ronni Mayasen Tejeda
• Maydel Medical Center Corp
• Marlin Mayea Matos

• Physical Therapy Clinic/Center in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; 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.