Lakewood Ranch Medical Massage, LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA40424 Issued in FL

Legal business name

LAKEWOOD RANCH MEDICAL MASSAGE, LLC

Practice address

9070 58TH Dr E Ste 102
Bradenton, FL 34202-6110

Phone

(941) 321-5311

Fax

(941) 321-5311

NPI assigned

Jun 18, 2017

Organization subpart

No

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

Authorized official

Name

Elizabeth Nicole Pugh, LMT

Title

Owner / Therapist

Phone

(941) 321-5311

Specialties & licenses 1

Addresses

Other names 1

• Mad Science Massage Doing business as

Locations

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497744000000",
    "number": "1104356591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11161 E STATE ROAD 70 STE 110-360",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342029407",
            "telephone_number": "941-321-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9070 58TH DR E STE 102",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342026110",
            "telephone_number": "941-321-5311",
            "fax_number": "941-321-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEWOOD RANCH MEDICAL MASSAGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-18",
        "last_updated": "2017-06-18",
        "status": "A",
        "authorized_official_last_name": "PUGH",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER / THERAPIST",
        "authorized_official_telephone_number": "941-321-5311",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA40424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mad Science Massage",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mad Science Massage",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lakewood Ranch Chiropractic Inc
• Lakewood Ranch Counseling
• Lakewood Ranch Counseling, LLC.
• Lakewood Ranch Imaging Center
• Lakewood Ranch Medical Center
• Lakewood Ranch Pediatrics
• Lakewood Ranch Premier Care
• Lakewood Ranch Primary Care Associates
• Lakewood Ranch Urgent Care P a
• Lakewood Ranch Urgent Care, PA

• Massage Therapist in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2017; 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.