Eden Massage & Spa, Inc

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

LIC #19555 Issued in FL

Legal business name

EDEN MASSAGE & SPA, INC

Practice address

2655 E Oakland Park Blvd
Suite #2
Fort Lauderdale, FL 33306-1608

Phone

(954) 564-9536

Fax

(954) 565-2910

NPI assigned

May 19, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Grace Okon Paul, LMT

Title

Owner/President

Phone

(954) 564-9536

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1194982140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 E OAKLAND PARK BLVD",
            "address_2": "SUITE #2",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061608",
            "telephone_number": "954-564-9536",
            "fax_number": "954-565-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 E OAKLAND PARK BLVD",
            "address_2": "SUITE #2",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333061608",
            "telephone_number": "954-564-9536",
            "fax_number": "954-565-2910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDEN MASSAGE & SPA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "PAUL",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "OKON",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "954-564-9536",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "LIC #19555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED WAIVER",
            "identifier": "686157196",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Eckardt
• Daphne Gabrielle Eckembrecher, MD, MPH
• Stephanie Dawn Ecott, M.S.
• Yessenia Espejo Eddy, CRNA
• Gail Edelman
• Edgar B Bolton DO PA
• Edge Medical Services
• Edify Counseling Group LLC
• Neil Harvey Edison, M.D.
• Richard Bruce Edison, M.D.

• Massage Therapist in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.