Ma Joanna Bergonia Torres

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

1616 Oak Ave
Lake Placid, FL 33852-5787

Phone

(863) 243-8268

NPI assigned

Aug 18, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ma Joanna Torres Palmer Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483315200000",
    "number": "1891240917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 OAK AVE",
            "city": "LAKE PLACID",
            "state": "FL",
            "postal_code": "338525787",
            "telephone_number": "863-243-8268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 OAK AVE",
            "city": "LAKE PLACID",
            "state": "FL",
            "postal_code": "338525787",
            "telephone_number": "863-243-8268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORRES",
        "first_name": "MA JOANNA",
        "middle_name": "BERGONIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-18",
        "last_updated": "2017-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USCIS",
            "identifier": "059-834-837",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MA JOANNA",
            "last_name": "PALMER",
            "middle_name": "TORRES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Developmental Therapist in Lake Placid, FL
• Providers in Lake Placid, FL by specialty
• Developmental Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2017; 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.