Active NPI
Raul Pellicane, LMT
- Massage Therapist
- Altamonte Springs, FL
National Provider Identifier
1043636350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA68430
- Practice address
- 623 Calibre Crest Pkwy
Apt 101
Altamonte Springs, FL 32714-3650 - Phone
- (561) 339-9236
- NPI assigned
- Mar 11, 2014
- Last updated
- Mar 11, 2014
- Sex
- Male
- 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 | MA68430 | FL | Primary |
Addresses
Primary practice location
623 Calibre Crest Pkwy
Apt 101
Altamonte Springs, FL 32714-3650
Mailing address
623 Calibre Crest Pkwy
Apt 101
Altamonte Springs, FL 32714-3650
Phone (561) 339-9236
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 |
|---|---|---|---|
| MA68430 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394496000000",
"number": "1043636350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "623 CALIBRE CREST PKWY",
"address_2": "APT 101",
"city": "ALTAMONTE SPRINGS",
"state": "FL",
"postal_code": "327143650",
"telephone_number": "561-339-9236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "623 CALIBRE CREST PKWY",
"address_2": "APT 101",
"city": "ALTAMONTE SPRINGS",
"state": "FL",
"postal_code": "327143650",
"telephone_number": "561-339-9236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELLICANE",
"first_name": "RAUL",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-03-11",
"last_updated": "2014-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA68430",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Mar 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.