NPIMap

Organization Active NPI

Ronda Panucci Massage, LLC

  • Massage Therapist
  • Crestview, FL
National Provider Identifier
1144343344
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA0016952 Issued in FL
Legal business name
RONDA PANUCCI MASSAGE, LLC
Practice address
1078 S Ferdon Blvd
Suite B
Crestview, FL 32536-4510
Phone
(850) 683-1125
Fax
(850) 683-0981
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ronda Lee Panucci, LMTNPI 1508895368
Title
Owner
Phone
(850) 683-1125

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X MA0016952 FL Primary

Addresses

Primary practice location

1078 S Ferdon Blvd
Suite B
Crestview, FL 32536-4510

Mailing address

PO Box 204
Crestview, FL 32536-0204
Phone (850) 683-1125

Other identifiers 1

IdentifierTypeStateIssuer
C6565OtherFLBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

1078 S Ferdon Blvd
Ste B
Crestview, FL 32536
Phone (850) 683-1125

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144343344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 204",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325360204",
            "telephone_number": "850-683-1125",
            "fax_number": "850-683-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1078 S FERDON BLVD",
            "address_2": "SUITE B",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325364510",
            "telephone_number": "850-683-1125",
            "fax_number": "850-683-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONDA PANUCCI MASSAGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PANUCCI",
        "authorized_official_first_name": "RONDA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-683-1125",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA0016952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "C6565",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.