Active NPI
Mariella Rengifo, LICENSED MASSAGE THE
- Massage Therapist
- Plantation, FL
National Provider Identifier
1114136009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA 26202
- Practice address
- 1852 N Nob Hill Rd
Holistic Massage & Wellness Clinics
Plantation, FL 33322-6548 - Phone
- (954) 476-6401
- NPI assigned
- May 21, 2007
- 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 26202 | FL | Primary |
Addresses
Primary practice location
1852 N Nob Hill Rd
Holistic Massage & Wellness Clinics
Plantation, FL 33322-6548
Mailing address
4205 N University Dr
Apartment 307
Sunrise, FL 33351
Phone (954) 854-0974
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 26202 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114136009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4205 N UNIVERSITY DR",
"address_2": "APARTMENT 307",
"city": "SUNRISE",
"state": "FL",
"postal_code": "33351",
"telephone_number": "954-854-0974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1852 N NOB HILL RD",
"address_2": "HOLISTIC MASSAGE & WELLNESS CLINICS",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333226548",
"telephone_number": "954-476-6401"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENGIFO",
"first_name": "MARIELLA",
"name_prefix": "Mrs.",
"credential": "LICENSED MASSAGE THE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA 26202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plantation, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.