Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Shannine Banawa Consolacion

Individual provider Physical Therapist · NPI 1063252054

MS. Shannine Banawa Consolacion is a Physical Therapist in Private Practice in Sunrise, Florida. Qualified in 2021, 5 years ago. Practices with Serc Rebabilitation Partners, LLC, a 211-clinician group and accepts Medicare assignment. Licensed in Connecticut and Indiana.

Years since qualifying
5
Licensed in
CT, IN
In the registry since
2024
Specialties on file
2
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Practice location Address checks out

1580 Sawgrass Corporate Pkwy
Sunrise, FL 33323-2869
Phone: (943) 216-2228
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 12577 (CT)
Physical Therapist Taxonomy 225100000X · Licence 0515944A (IN)

Record details

NPI number1063252054
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 28, 2024
Last updated in NPPESNovember 4, 2025
Certification dateNovember 4, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Serc Rebabilitation Partners, Llc — 211 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Sunrise