Active NPI
Leonard Manuel Lopez de la Torre
- Massage Therapist
- Tampa, FL
National Provider Identifier
1104474592
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(4) exclusion effective Jul 18, 2024.
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA90945
- Practice address
- 3709 W Hamilton Ave Ste 4
Tampa, FL 33614-4015 - Phone
- (813) 374-4498
- NPI assigned
- Aug 28, 2019
- Sex
- Male
- 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 | MA90945 | FL | Primary |
Addresses
Primary practice location
3709 W Hamilton Ave Ste 4
Tampa, FL 33614-4015
Mailing address
3709 W Hamilton Ave
Tampa, FL 33614-4015
Phone (813) 374-4498
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA90945 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566950400000",
"number": "1104474592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3709 W HAMILTON AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336144015",
"telephone_number": "813-374-4498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3709 W HAMILTON AVE STE 4",
"city": "TAMPA",
"state": "FL",
"postal_code": "336144015",
"telephone_number": "813-374-4498"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOPEZ DE LA TORRE",
"first_name": "LEONARD",
"middle_name": "MANUEL",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-08-28",
"last_updated": "2019-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA90945",
"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 Aug 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.