Go Madd 4 Massage

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MM16790 Issued in FL

Legal business name

GO MADD 4 MASSAGE

Practice address

2600 US Highway 1 S Ste 7
St Augustine, FL 32086-6193

Phone

(904) 708-1083

NPI assigned

Sep 7, 2016

Organization subpart

No

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

Authorized official

Name

Diana Carol BeranekNPI 1588111629

Title

Owner

Phone

(904) 708-1083

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Diana Carol Beranek

  • Massage Therapist
  • St Augustine, FL
  • NPI 1588111629
  NPD (past) Authorized official

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473206400000",
    "number": "1346797495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 US HIGHWAY 1 S STE 7",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866193",
            "telephone_number": "904-708-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 US HIGHWAY 1 S STE 7",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866193",
            "telephone_number": "904-708-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GO MADD 4 MASSAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A",
        "authorized_official_last_name": "BERANEK",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-708-1083"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MM16790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Glod
• Gloria Jean Lelaidier
• Gloria Z. Moore D.C., P.a.
• Rhiannon Gluhosky, DPT
• Eunice Martina Glynn, OTR/L
• Stacia Larose Godboldt, CNM
• Deborah Jean Goddard, ARNP
• Kristin Goebel
• David S Goins, PA
• Wynde Goins, PA-C

• Massage Therapist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.