Jason A. Peralta, PT
Physical Therapist in Lakeland, FL. Individual provider (NPI-1).
NPI number1962065284
StatusActive
Last updated in NPPESApr 22, 2019
Details
- NPI
- 1962065284
- Entity type
- Individual (NPI-1)
- Name
- Jason A. Peralta
- Credential
- PT
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 22, 2019
- Last updated
- Apr 22, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | PT25169 | FL | Yes |
Practice location
771 Carpenters WayLakeland, FL 33809-3922
Phone 727-803-1102
Mailing address
260 1st Ave S Ste 200Saint Petersburg, FL 33701-4364
Phone 727-803-1102 · Fax 727-502-6027
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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