Active NPI
Johanny Vizcarrondo Colon
- Physical Therapist
- Port Charlotte, FL
National Provider Identifier
1942469234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1182
- Practice address
- 24011 Madaca Lane # 108
Port Charlotte, FL 33954 - Phone
- (787) 550-7835
- NPI assigned
- Jun 3, 2008
- Last updated
- Aug 20, 2009
- Sex
- Female
- 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 Therapist | 225100000X | 1182 | PR | Primary |
Addresses
Primary practice location
24011 Madaca Lane # 108
Port Charlotte, FL 33954
Mailing address
24011 Madaca Lane # 108
Port Charlotte, FL 33954
Phone (787) 550-7835
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 |
|---|---|---|---|
| 1182 | PR | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250726400000",
"number": "1942469234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24011 MADACA LANE # 108",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "33954",
"telephone_number": "787-550-7835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24011 MADACA LANE # 108",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "33954",
"telephone_number": "787-550-7835"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIZCARRONDO COLON",
"first_name": "JOHANNY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-03",
"last_updated": "2009-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PR",
"license": "1182",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.