Raphaella Petrosino, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL4199 Issued in FL

Practice address

5030 Champion Blvd Ste D9
Boca Raton, FL 33496-2497

Phone

(561) 432-0111

NPI assigned

May 11, 2016

Sex

Female

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)

Not enrolled

State licenses

Practice roles

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.

• Gold Coast Physical Therapy Associates LLC

  • Physical Therapy Clinic/Center
  • Lake Worth, FL
  • NPI 1114026523
  NPD (past)
• Gold Coast Physical Therapy Associates, LLC

  • Physical Therapy Clinic/Center
  • Boca Raton, FL
  • NPI 1609205673
  NPD (past)

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

{
    "created_epoch": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462924800000",
    "number": "1982050720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 CHAMPION BLVD STE D9",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334962497",
            "telephone_number": "561-432-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 CHAMPION BLVD STE D9",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334962497",
            "telephone_number": "561-432-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSINO",
        "first_name": "RAPHAELLA",
        "name_prefix": "Miss",
        "credential": "ATC, LAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-11",
        "last_updated": "2016-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL4199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sima Petilli
• Carla Petion
• Luthny Petitdo
• Elizabeth Ann Petlev, MSCCCSLP
• Jaclyn Ann Petrassi, M.A., CCC-SLP
• Leanne Petrouske, PHARM D
• Michelle Petru
• Margaret Carthas Petry, PH.D.
• Lenore Petta, RDN, LDN
• Alexandra Pettas

• Athletic Trainer in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2016; 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.