Samuel David Pace, MSCD, LMT

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA20387 Issued in FL

Practice address

4209-1 University Blvd S
Jacksonville, FL 32216-4907

Phone

(904) 737-9553

NPI assigned

Mar 19, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306960158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4209-1 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164907",
            "telephone_number": "904-737-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4209-1 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164907",
            "telephone_number": "904-737-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACE",
        "first_name": "SAMUEL",
        "middle_name": "DAVID",
        "credential": "MSCD, LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "MA20387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSGE ESTABLISHMENT",
            "identifier": "M9926",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE THEAPY LICENSE",
            "identifier": "MA30387",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pace Partners of Northeast Florida, Inc.
• Georgia Pace
• Heather Leigh Pace, MS, RDN
• Megan Pace
• Olicia C Pace
• Brittany Anne Pacella, MA
• Frank Oliver Pacetti, PA-C
• Pacifica Augustine Road LLC
• Pacifica Care PLLC
• Breah Lynn Paciotti, PA-C

• Specialist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.