Individual provider Active NPI

Manuel Alejandro Valderrama, OTR

  • Physical Rehabilitation Occupational Therapist
  • Cutler Bay, FL
National Provider Identifier
1902173644
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
OT-2567 Issued in NV
Practice address
18951 SW 106TH Ave Ste 110
Cutler Bay, FL 33157-7670
Phone
(305) 233-4448
NPI assigned
Nov 23, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X OT-2567 NV Primary

Addresses

Primary practice location

18951 SW 106TH Ave Ste 110
Cutler Bay, FL 33157-7670

Mailing address

7213 Elite CT
Las Vegas, NV 89129-5988
Phone (786) 419-7379

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
OT-2567NVMDPhysical Rehabilitation Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1902173644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7213 ELITE CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891295988",
            "telephone_number": "786-419-7379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18951 SW 106TH AVE STE 110",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331577670",
            "telephone_number": "305-233-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDERRAMA",
        "first_name": "MANUEL",
        "middle_name": "ALEJANDRO",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-23",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NV",
            "license": "OT-2567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cutler Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.