Katherine Soo Tian Tan

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA43645 Issued in FL

Practice address

570 Ocean Dr
Holistic Manage & Wellness Clinics # 501
Juno Beach, FL 33408

Phone

(954) 491-2225

Fax

(954) 491-6862

NPI assigned

Mar 8, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Holistic Massage & Wellness Clinics

  • Massage Therapist
  • Fort Lauderdale, FL
  • NPI 1578694915
  NPD (past)

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306977590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 SOUTH OCEAN DRIVE",
            "address_2": "APT 803",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330192369",
            "telephone_number": "954-922-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 OCEAN DR",
            "address_2": "HOLISTIC MANAGE & WELLNESS CLINICS # 501",
            "city": "JUNO BEACH",
            "state": "FL",
            "postal_code": "33408",
            "telephone_number": "954-491-2225",
            "fax_number": "954-491-6862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "KATHERINE",
        "middle_name": "SOO TIAN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA43645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Juno Beach, FL
• Providers in Juno Beach, FL by specialty
• Massage Therapist 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.