Pro Massage

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MM34066 Issued in FL

Legal business name

PRO MASSAGE

Practice address

621 Market St
St Augustine, FL 32095-8892

Phone

(904) 540-1198

NPI assigned

Sep 10, 2015

Organization subpart

No

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

Authorized official

Name

Melba Faye Peludat, LMT

Title

Owner

Phone

(904) 655-3670

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441843200000",
    "number": "1356719116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 MARKET ST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320958892",
            "telephone_number": "904-540-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 MARKET ST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320958892",
            "telephone_number": "904-540-1198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO MASSAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-10",
        "last_updated": "2015-09-10",
        "status": "A",
        "authorized_official_last_name": "PELUDAT",
        "authorized_official_first_name": "MELBA",
        "authorized_official_middle_name": "FAYE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-655-3670",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MM34066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 10, 2015; 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.