Rosendo Odronia Odevilas, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT27362 Issued in FL

Practice address

1460 El Camino Real
Lady Lake, FL 32159-0040

Phone

(352) 750-0866

NPI assigned

May 24, 2012

Last updated

Feb 23, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1972863892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3326 BOYD CIR",
            "city": "OXFORD",
            "state": "FL",
            "postal_code": "344843589",
            "telephone_number": "954-804-6574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 EL CAMINO REAL",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321590040",
            "telephone_number": "352-750-0866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1580 Sawgrass Corporate Pkwy",
            "address_purpose": "LOCATION",
            "city": "Sunrise",
            "state": "FL",
            "postal_code": "333232859",
            "country_code": "US",
            "telephone_number": "954-804-6574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODEVILAS",
        "first_name": "ROSENDO",
        "middle_name": "ODRONIA",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-24",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT27362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Lady Lake, FL
• Providers in Lady Lake, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.