Individual provider Active NPI

Andrew Vevoda, PT

  • Physical Therapist
  • Sun City Center, FL
National Provider Identifier
1922773498
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
37568 Issued in FL
Practice address
3800 Sun City Center Blvd
Sun City Center, FL 33573-6805
Phone
(813) 633-9888
NPI assigned
Aug 16, 2021
Last updated
Aug 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 37568 FL Primary

Addresses

Primary practice location

3800 Sun City Center Blvd
Sun City Center, FL 33573-6805

Mailing address

2607 Bermuda Lake Dr Apt 302
Brandon, FL 33510-2282
Phone (757) 651-3536

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
37568FLMDPhysical Therapist

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1922773498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2607 BERMUDA LAKE DR APT 302",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335102282",
            "telephone_number": "757-651-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 SUN CITY CENTER BLVD",
            "city": "SUN CITY CENTER",
            "state": "FL",
            "postal_code": "335736805",
            "telephone_number": "813-633-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEVODA",
        "first_name": "ANDREW",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "37568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City Center, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.