Ship Shape Water Fitness Specialists, LLC

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

License

AFAA 32385 Issued in FL

Legal business name

SHIP SHAPE WATER FITNESS SPECIALISTS, LLC

Practice address

47 Kalamazoo TRL
Palm Coast, FL 32164-5633

Phone

(386) 986-5655

Fax

(386) 313-1886

NPI assigned

Dec 7, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Sharon M. Smith, AFAA TRAINER

Title

Fitness Trainer

Phone

(386) 986-5655

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1354838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354838400000",
    "number": "1356686943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 KALAMAZOO TRL",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645633",
            "telephone_number": "386-986-5655",
            "fax_number": "386-313-1886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 KALAMAZOO TRL",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645633",
            "telephone_number": "386-986-5655",
            "fax_number": "386-313-1886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIP SHAPE WATER FITNESS SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-07",
        "last_updated": "2012-12-07",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "FITNESS TRAINER",
        "authorized_official_telephone_number": "386-986-5655",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "AFAA TRAINER"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "FL",
            "license": "AFAA 32385",
            "primary": true
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "FL",
            "license": "AEA 60145",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Public Health or Welfare Agency in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Public Health or Welfare Agency in Florida

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

Verify at the official NPI Registry.