Active NPI
Kelly Jo Dottore, PT
- Physical Therapist
- Casselberry, FL
National Provider Identifier
1992856140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 22399
- Practice address
- 1211 Semoran Blvd Ste 227
Casselberry, FL 32707-6442 - Phone
- (407) 681-2999
- NPI assigned
- Jan 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 22399 | FL | Primary |
Addresses
Primary practice location
1211 Semoran Blvd Ste 227
Casselberry, FL 32707-6442
Mailing address
636 Holbrook Cir
Lake Mary, FL 32746-6334
Phone (407) 924-7236
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22399 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416787200000",
"number": "1992856140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "636 HOLBROOK CIR",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327466334",
"telephone_number": "407-924-7236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1211 SEMORAN BLVD STE 227",
"city": "CASSELBERRY",
"state": "FL",
"postal_code": "327076442",
"telephone_number": "407-681-2999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOTTORE",
"first_name": "KELLY",
"middle_name": "JO",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-15",
"last_updated": "2014-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "22399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Casselberry, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.