Individual provider Active NPI

Tawnya Bagnasco, LMT

  • Massage Therapist
  • Fruitland Park, FL
National Provider Identifier
1225737042
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
89586 Issued in FL
Practice address
3261 US Hwy 441
Suite D-2
Fruitland Park, FL 34731
Phone
(352) 314-6599
NPI assigned
Mar 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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 89586 FL Primary

Addresses

Primary practice location

3261 US Hwy 441
Suite D-2
Fruitland Park, FL 34731

Mailing address

3261 US Hwy 441
Suite D-2
Fruitland Park, FL 34731
Phone (352) 314-6599

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
89586FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1225737042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3261 US HWY 441",
            "address_2": "SUITE D-2",
            "city": "FRUITLAND PARK",
            "state": "FL",
            "postal_code": "34731",
            "telephone_number": "352-314-6599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3261 US HWY 441",
            "address_2": "SUITE D-2",
            "city": "FRUITLAND PARK",
            "state": "FL",
            "postal_code": "34731",
            "telephone_number": "352-314-6599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGNASCO",
        "first_name": "TAWNYA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-01",
        "last_updated": "2023-03-01",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "89586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fruitland Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.