Individual provider Active NPI

Juan Pablo Wilches, PTA

  • Physical Therapy Assistant
  • Miami, FL
National Provider Identifier
1972151140
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA29637 Issued in FL
Practice address
1081 NW 129TH Ave
Miami, FL 33182-2324
Phone
(305) 305-3240
NPI assigned
Aug 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA29637 FL Primary

Addresses

Primary practice location

1081 NW 129TH Ave
Miami, FL 33182-2324

Mailing address

1081 NW 129TH Ave
Miami, FL 33182-2324
Phone (305) 305-3240

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
PTA29637FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1972151140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 NW 129TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331822324",
            "telephone_number": "305-305-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1081 NW 129TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331822324",
            "telephone_number": "305-305-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCHES",
        "first_name": "JUAN",
        "middle_name": "PABLO",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-29",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA29637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; 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.