Active NPI
Ovidio Olivencia, M.P.T.
- Physical Therapist
- Davie, FL
National Provider Identifier
1922181700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT20448
- Practice address
- 8622 W State Road 84
Davie, FL 33324-4567 - Phone
- (954) 472-7526
- Fax
- (954) 472-5605
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- 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 | PT20448 | FL | Primary |
Addresses
Primary practice location
8622 W State Road 84
Davie, FL 33324-4567
Mailing address
1502 Jefferson Ave Apt 302
Miami Beach, FL 33139-3483
Phone (954) 610-0066
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT20448 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Accucare Inc | Physical Therapist | 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.
-
- Physical Therapist
- Davie, FL
- NPI 1518049162
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278547200000",
"number": "1922181700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1502 JEFFERSON AVE APT 302",
"city": "MIAMI BEACH",
"state": "FL",
"postal_code": "331393483",
"telephone_number": "954-610-0066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8622 W STATE ROAD 84",
"city": "DAVIE",
"state": "FL",
"postal_code": "333244567",
"telephone_number": "954-472-7526",
"fax_number": "954-472-5605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVENCIA",
"first_name": "OVIDIO",
"credential": "M.P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2010-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT20448",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.