Individual provider Active NPI

Walter Jaramillo

  • Massage Therapist
  • Aventura, FL
National Provider Identifier
1063626661
Registry record updated Apr 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA28268 Issued in FL
Practice address
17971 Biscayne Blvd Ste 110
Aventura, FL 33160-2531
Phone
(786) 738-4634
NPI assigned
May 10, 2007
Last updated
Apr 2, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA28268 FL Primary

Addresses

Primary practice location

17971 Biscayne Blvd Ste 110
Aventura, FL 33160-2531

Mailing address

2331 Yucca Ave
Pembroke Pines, FL 33026-1734
Phone (786) 738-4634

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

LicenseStateTypeSpecialty
MA28268FLMDMassage Therapist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522627200000",
    "number": "1063626661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 YUCCA AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330261734",
            "telephone_number": "786-738-4634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17971 BISCAYNE BLVD STE 110",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331602531",
            "telephone_number": "786-738-4634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARAMILLO",
        "first_name": "WALTER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2018-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA28268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2018; 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.