Individual provider Active NPI

Julian Andres Ceron

  • Physical Therapist
  • Kissimmee, FL
National Provider Identifier
1902426638
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT42957 Issued in FL
Practice address
111 E Monument Ave Unit 410
Kissimmee, FL 34741-5774
Phone
(407) 904-5285
Fax
(407) 987-5236
NPI assigned
Apr 22, 2020
Last updated
Mar 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT42957 FL Primary
Physical Therapist 225100000X 045750-01 NY

Addresses

Primary practice location

111 E Monument Ave Unit 410
Kissimmee, FL 34741-5774

Mailing address

2400 Knightsbridge Blvd
Kissimmee, FL 34744-8453
Phone (908) 986-4169

Other practice location 1

535 Flushing Ave
Brooklyn, NY 11205-1610
Phone (929) 800-2340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260501000004 FL Practitioner - Physical Therapist in Private Practice 0042641540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evolve Neuro Therapy LLCGroup PAC ID 6406348820, 7 clinicians

Practice addresses (Care Compare)

111 E Monument Ave
Unit 410
Kissimmee, FL 34741-5774
Phone (407) 904-5285

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT42957FLMDPhysical Therapist
045750-01NYMDPhysical Therapist

Organizations & group practices 1

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": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1902426638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 KNIGHTSBRIDGE BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347448453",
            "telephone_number": "908-986-4169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E MONUMENT AVE UNIT 410",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415774",
            "telephone_number": "407-904-5285",
            "fax_number": "407-987-5236"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "535 Flushing Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112051610",
            "country_code": "US",
            "telephone_number": "929-800-2340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CERON",
        "first_name": "JULIAN",
        "middle_name": "ANDRES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-22",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT42957",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "045750-01",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.