Active NPI
Alyse Cosima Rodriguez, LMT
- Massage Therapist
- Jacksonville, FL
National Provider Identifier
1033418165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA 59574
- Practice address
- 3576 Saint Johns Ave
Jacksonville, FL 32205-8446 - Phone
- (904) 387-9355
- Fax
- (904) 387-6701
- NPI assigned
- Mar 15, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA 59574 | FL | Primary |
Addresses
Primary practice location
3576 Saint Johns Ave
Jacksonville, FL 32205-8446
Mailing address
8450 Gate Pkwy W # 16254
Jacksonville, FL 32216-1049
Phone (904) 352-5292
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 |
|---|---|---|---|
| MA 59574 | FL | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| K and L Fitness, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Jacksonville, FL
- NPI 1285745968
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300147200000",
"number": "1033418165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8450 GATE PKWY W # 16254",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322161049",
"telephone_number": "904-352-5292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3576 SAINT JOHNS AVE",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322058446",
"telephone_number": "904-387-9355",
"fax_number": "904-387-6701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "ALYSE",
"middle_name": "COSIMA",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-15",
"last_updated": "2011-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA 59574",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.