Active NPI
Emiliano D Tesalona Jr., LMT
- Mechanotherapist
- Port St Lucie, FL
National Provider Identifier
1013241157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- MA15944
- Practice address
- 162 NW Swann Mill Cir
Port St Lucie, FL 34986-3592 - Phone
- (772) 285-5403
- Fax
- (772) 345-4979
- NPI assigned
- Sep 22, 2009
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | MA15944 | FL | Primary |
Addresses
Primary practice location
162 NW Swann Mill Cir
Port St Lucie, FL 34986-3592
Mailing address
162 NW Swann Mill Cir
Port St Lucie, FL 34986-3592
Phone (772) 285-5403
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 |
|---|---|---|---|
| MA15944 | FL | MD | Mechanotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306281600000",
"number": "1013241157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "162 NW SWANN MILL CIR",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349863592",
"telephone_number": "772-285-5403",
"fax_number": "772-345-4979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "162 NW SWANN MILL CIR",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349863592",
"telephone_number": "772-285-5403",
"fax_number": "772-345-4979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TESALONA",
"first_name": "EMILIANO",
"middle_name": "D",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-09-22",
"last_updated": "2011-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "FL",
"license": "MA15944",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.