Active NPI
Jennifer Lynne Bodanza, L.M.T
- Massage Therapist
- Tampa, FL
National Provider Identifier
1063641629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA 36001
- Practice address
- 10323 Cross Creek Blvd Ste B
Tampa, FL 33647-2988 - Phone
- (813) 325-1296
- NPI assigned
- Jul 3, 2009
- Last updated
- Jul 3, 2009
- 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 36001 | FL | Primary |
Addresses
Primary practice location
10323 Cross Creek Blvd Ste B
Tampa, FL 33647-2988
Mailing address
30624 Bittsbury CT
Wesley Chapel, FL 33543-3925
Phone (813) 333-4032
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 36001 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246579200000",
"number": "1063641629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30624 BITTSBURY CT",
"city": "WESLEY CHAPEL",
"state": "FL",
"postal_code": "335433925",
"telephone_number": "813-333-4032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10323 CROSS CREEK BLVD STE B",
"city": "TAMPA",
"state": "FL",
"postal_code": "336472988",
"telephone_number": "813-325-1296"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BODANZA",
"first_name": "JENNIFER",
"middle_name": "LYNNE",
"name_prefix": "Mrs.",
"credential": "L.M.T",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-03",
"last_updated": "2009-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA 36001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.