Active NPI
Julie L Allen, LMT
- Massage Therapist
- Mount Dora, FL
National Provider Identifier
1306190210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA36704
- Practice address
- 4400 N Highway 19a # 12
Mount Dora, FL 32757-2032 - Phone
- (352) 357-5000
- NPI assigned
- Oct 30, 2012
- Sex
- Female
- Sole proprietor
- No
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA36704 | FL | MD | Massage Therapist |
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA36704 | FL | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
4400 N Highway 19a # 12
Mount Dora, FL 32757-2032
Mailing address
4400 N Highway 19a # 12
Mount Dora, FL 32757-2032
Phone (352) 357-5000
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| C2690 | Other | FL | FLORIDA BLUE |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 30, 2012.
{
"created_epoch": "1351555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351555200000",
"number": "1306190210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4400 N HIGHWAY 19A # 12",
"city": "MOUNT DORA",
"state": "FL",
"postal_code": "327572032",
"telephone_number": "352-357-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4400 N HIGHWAY 19A # 12",
"city": "MOUNT DORA",
"state": "FL",
"postal_code": "327572032",
"telephone_number": "352-357-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "JULIE",
"middle_name": "L",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-30",
"last_updated": "2012-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA36704",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FLORIDA BLUE",
"identifier": "C2690",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mount Dora, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.