Carmen Rosa Kennedy, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

9747 Issued in FL

Practice address

9057 Garland Ave
Surfside, FL 33154-3217

Phone

(786) 316-8826

NPI assigned

Aug 14, 2017

Last updated

Aug 14, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• C Rosa Kennedy Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1502668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502668800000",
    "number": "1992221733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9057 GARLAND AVE",
            "city": "SURFSIDE",
            "state": "FL",
            "postal_code": "331543217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9057 GARLAND AVE",
            "city": "SURFSIDE",
            "state": "FL",
            "postal_code": "331543217",
            "telephone_number": "786-316-8826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "CARMEN",
        "middle_name": "ROSA",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-14",
        "last_updated": "2017-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "9747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "C",
            "last_name": "KENNEDY",
            "middle_name": "ROSA",
            "credential": "PTA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• In Motion PT, Inc.
• Iris Fox LCSW LLC
• Sarit J Itenberg, DO
• Marissa Jade Jacobson, MS CCC SLP
• Judith Kaplan, C.N.M., A.R.N.P.
• Noel E Lastre Mendoza
• Erika Eunice Lawrence Robinson
• Mera Levin, OTRL
• Jennifer M Lopez, DMD
• Lovecareresearch

• Physical Therapy Assistant in Surfside, FL
• Providers in Surfside, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2017; 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.