Active NPI
Suzy Urenda
- Physical Therapist
- Fort Walton Beach, FL
National Provider Identifier
1912201872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 13466
- Practice address
- 405 Racetrack Rd NE
Suite 101
Fort Walton Beach, FL 32547-2561 - Phone
- (850) 863-4747
- NPI assigned
- Jan 6, 2011
- Sex
- Female
- Sole proprietor
- No
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 Therapist | 225100000X | 13466 | FL | Primary |
Addresses
Primary practice location
405 Racetrack Rd NE
Suite 101
Fort Walton Beach, FL 32547-2561
Mailing address
505 Sioux Cir
Fort Walton Beach, FL 32547-3535
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 |
|---|---|---|---|
| 13466 | FL | MD | Community Health Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabcare Group East, LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Rehabilitation Clinic/Center
- Shalimar, FL
- NPI 1407382278
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294272000000",
"number": "1912201872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 SIOUX CIR",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325473535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 RACETRACK RD NE",
"address_2": "SUITE 101",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325472561",
"telephone_number": "850-863-4747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "URENDA",
"first_name": "SUZY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-06",
"last_updated": "2011-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "13466",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Walton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.