Individual provider Active NPI

Veronica Miedema

  • Massage Therapist
  • Winter Park, FL
National Provider Identifier
1124486923
Registry record updated Feb 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
74543 Issued in FL
Practice address
525 N Park Ave
121
Winter Park, FL 32789-3227
Phone
(407) 492-2932
NPI assigned
Feb 8, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2016

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 74543 FL Primary

Addresses

Primary practice location

525 N Park Ave
121
Winter Park, FL 32789-3227

Mailing address

525 N Park Ave
121
Winter Park, FL 32789-3227
Phone (407) 492-2932

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
74543FLMDAnesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454889600000",
    "number": "1124486923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N PARK AVE",
            "address_2": "121",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327893227",
            "telephone_number": "407-492-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N PARK AVE",
            "address_2": "121",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327893227",
            "telephone_number": "407-492-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIEDEMA",
        "first_name": "VERONICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-08",
        "last_updated": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "74543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; 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.