Active NPI
Bonnie Sue Rheault, LMT
- Massage Therapist
- Altamonte Springs, FL
National Provider Identifier
1013285675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA48041
- Practice address
- 224 W Central Pkwy
Suite 1010
Altamonte Springs, FL 32714-2545 - Phone
- (407) 697-0697
- Fax
- (407) 668-4100
- NPI assigned
- Dec 9, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA48041 | FL | Primary |
Addresses
Primary practice location
224 W Central Pkwy
Suite 1010
Altamonte Springs, FL 32714-2545
Mailing address
645 Elm Creek CT
Altamonte Springs, FL 32714-1818
Phone (407) 697-0697
Other names 1
- Bonnie Rheault Wyzykowski
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 |
|---|---|---|---|
| MA48041 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323388800000",
"number": "1013285675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "645 ELM CREEK CT",
"city": "ALTAMONTE SPRINGS",
"state": "FL",
"postal_code": "327141818",
"telephone_number": "407-697-0697",
"fax_number": "407-668-4100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 W CENTRAL PKWY",
"address_2": "SUITE 1010",
"city": "ALTAMONTE SPRINGS",
"state": "FL",
"postal_code": "327142545",
"telephone_number": "407-697-0697",
"fax_number": "407-668-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RHEAULT",
"first_name": "BONNIE",
"middle_name": "SUE",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-09",
"last_updated": "2011-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA48041",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BONNIE",
"last_name": "WYZYKOWSKI",
"middle_name": "RHEAULT",
"credential": "LMT",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Altamonte Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.