Individual provider Active NPI

Dexter S. Mulles, P.T.

  • Physical Therapist
  • Cape Coral, FL
National Provider Identifier
1972566438
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT16961 Issued in FL
Practice address
632 Del Prado Blvd N
Suite 101
Cape Coral, FL 33909-2278
Phone
(239) 772-5577
Fax
(239) 772-9961
NPI assigned
Apr 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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 PT16961 FL Primary

Addresses

Primary practice location

632 Del Prado Blvd N
Suite 101
Cape Coral, FL 33909-2278

Mailing address

632 Del Prado Blvd N
Suite 101
Cape Coral, FL 33909-2278
Phone (239) 772-5577

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

LicenseStateTypeSpecialty
PT16961FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449014400000",
    "number": "1972566438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 DEL PRADO BLVD N",
            "address_2": "SUITE 101",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339092278",
            "telephone_number": "239-772-5577",
            "fax_number": "239-772-9961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 DEL PRADO BLVD N",
            "address_2": "SUITE 101",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339092278",
            "telephone_number": "239-772-5577",
            "fax_number": "239-772-9961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLES",
        "first_name": "DEXTER",
        "middle_name": "S.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2015-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT16961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; 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.