Individual provider Active NPI

Sandra Roldan, LMT

  • Massage Therapist
  • Hallandale Beach, FL
National Provider Identifier
1174847321
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA44797 Issued in FL
Practice address
1801 S Ocean Dr
Suite E
Hallandale Beach, FL 33009-4945
Phone
(954) 391-7864
Fax
(954) 391-8468
NPI assigned
Mar 17, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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 MA44797 FL Primary

Addresses

Primary practice location

1801 S Ocean Dr
Suite E
Hallandale Beach, FL 33009-4945

Mailing address

304 W Hallandale Beach Blvd
Hallandale Beach , FL 33009
Hallandale Beach, FL 33009-5444
Phone (954) 454-4280

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
MA44797FLMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Kenton PA Past Accepting new patients
Hand & Arm Therapy Specialist'S Inc. Past Accepting new patients
Lev Sudakov DC PA PastSince Jun 16, 2008 Accepting new patients
Natalia Sudakov, M.D., P.a. Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1174847321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 W HALLANDALE BEACH BLVD",
            "address_2": "HALLANDALE BEACH , FL 33009",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330095444",
            "telephone_number": "954-454-4280",
            "fax_number": "954-922-3841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 S OCEAN DR",
            "address_2": "SUITE E",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094945",
            "telephone_number": "954-391-7864",
            "fax_number": "954-391-8468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLDAN",
        "first_name": "SANDRA",
        "name_prefix": "Miss",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-17",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA44797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hallandale Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.