NPIMap

Organization Active NPI

Neuro Massage Therapist, Inc.

  • Massage Therapist
  • Fort Myers, FL
National Provider Identifier
1023231792
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MM16119 Issued in FL
Legal business name
NEURO MASSAGE THERAPIST, INC.
Practice address
8595 College Pkwy
Unit A2
Fort Myers, FL 33919-5191
Phone
(239) 489-2290
Fax
(239) 482-6028
NPI assigned
Apr 11, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Susan Sabella
Title
Credentialing Dept
Phone
(561) 241-1971

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MM16119 FL Primary

Addresses

Primary practice location

8595 College Pkwy
Unit A2
Fort Myers, FL 33919-5191

Mailing address

2295 NW Corporate Blvd
Suite 140
Boca Raton, FL 33431-7373
Phone (561) 241-1971

Other identifiers 1

IdentifierTypeStateIssuer
MM16119OtherFLLICENSE NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Neuro Massage Therapist Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8595 College Pkwy
Unit A2
Fort Myers, FL 33919
Phone (239) 489-2290

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023231792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2295 NW CORPORATE BLVD",
            "address_2": "SUITE 140",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334317373",
            "telephone_number": "561-241-1971",
            "fax_number": "561-241-3969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8595 COLLEGE PKWY",
            "address_2": "UNIT A2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339195191",
            "telephone_number": "239-489-2290",
            "fax_number": "239-482-6028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO MASSAGE THERAPIST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SABELLA",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CREDENTIALING DEPT",
        "authorized_official_telephone_number": "561-241-1971"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MM16119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "MM16119",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.