Individual provider Active NPI

Julissa M Abreu

  • Pediatric Physical Therapist
  • Boynton Beach, FL
National Provider Identifier
1972792653
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PT13654 Issued in FL
Practice address
2623 S Seacrest Blvd Lowr Level
Boynton Beach, FL 33435-7501
Phone
(561) 737-7733
NPI assigned
Oct 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X PT13654 FL Primary

Addresses

Primary practice location

2623 S Seacrest Blvd Lowr Level
Boynton Beach, FL 33435-7501

Mailing address

2623 S Seacrest Blvd Lowr Level
Boynton Beach, FL 33435-7501
Phone (561) 737-7733

Other names 1

  • Julissa A Bakardjiev Professional name

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
PT13654FLMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Movement Therapy Center-Boynton Beach Inc Pediatrics CurrentSince Feb 1, 2021 Accepting new patients
F.I.T. PT, LLC CurrentSince Jan 14, 2021 Accepting new patients
Florida Movement Therapy Center-Boca Raton, LLC Pediatrics CurrentSince Feb 1, 2021 Accepting new patients

Locations

950 Peninsula Corporate Cir
Ste 3004
Boca Raton, FL 33487
Phone (561) 501-1983

21345 Powerline Rd
Ste 100
Boca Raton, FL 33433
Phone (561) 883-7800

12040 S Jog Rd
Ste 8
Boynton Beach, FL 33437
Phone (561) 733-5083

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1972792653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2623 S SEACREST BLVD LOWR LEVEL",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334357501",
            "telephone_number": "561-737-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2623 S SEACREST BLVD LOWR LEVEL",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334357501",
            "telephone_number": "561-737-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABREU",
        "first_name": "JULISSA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-18",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "FL",
            "license": "PT13654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULISSA",
            "last_name": "BAKARDJIEV",
            "middle_name": "A",
            "credential": "PT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; 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.