Active NPI
Javier Medina, PTA
- Physical Therapy Assistant
- Homestead, FL
National Provider Identifier
1902363070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 29219
- Practice address
- 45 NW 8TH St Ste 108
Homestead, FL 33030-4452 - Phone
- (954) 995-7431
- NPI assigned
- Feb 25, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 29219 | FL | Primary |
Addresses
Primary practice location
45 NW 8TH St Ste 108
Homestead, FL 33030-4452
Mailing address
20780 SW 86TH PL
Cutler Bay, FL 33189-3839
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
| License | State | Type | Specialty |
|---|---|---|---|
| 29219 | FL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551052800000",
"number": "1902363070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20780 SW 86TH PL",
"city": "CUTLER BAY",
"state": "FL",
"postal_code": "331893839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 NW 8TH ST STE 108",
"city": "HOMESTEAD",
"state": "FL",
"postal_code": "330304452",
"telephone_number": "954-995-7431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "JAVIER",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-02-25",
"last_updated": "2019-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "29219",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Homestead, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.