Active NPI
Bryan Wayne Love
- Massage Therapist
- Lakewood Ranch, FL
National Provider Identifier
1326475385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA30231
- Practice address
- 9050 58TH Dr E
Suite #101
Lakewood Ranch, FL 34202-6104 - Phone
- (941) 807-5240
- NPI assigned
- Oct 4, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA30231 | FL | Primary |
Addresses
Primary practice location
9050 58TH Dr E
Suite #101
Lakewood Ranch, FL 34202-6104
Mailing address
5429 Carso Ter
North Port, FL 34286-6428
Phone (941) 429-6453
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 |
|---|---|---|---|
| MA30231 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380844800000",
"number": "1326475385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5429 CARSO TER",
"city": "NORTH PORT",
"state": "FL",
"postal_code": "342866428",
"telephone_number": "941-429-6453"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9050 58TH DR E",
"address_2": "SUITE #101",
"city": "LAKEWOOD RANCH",
"state": "FL",
"postal_code": "342026104",
"telephone_number": "941-807-5240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOVE",
"first_name": "BRYAN",
"middle_name": "WAYNE",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-10-04",
"last_updated": "2013-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA30231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lakewood Ranch, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.