Active NPI
Michele Rose Bellissimo, L.M.T.
- Specialist
- Palm Beach Gardens, FL
National Provider Identifier
1386754166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA47294
- Practice address
- 3375 Burns Rd
Ste. #104
Palm Beach Gardens, FL 33410-4349 - Phone
- (561) 624-1719
- Fax
- (561) 625-0768
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | MA47294 | FL | Primary |
Addresses
Primary practice location
3375 Burns Rd
Ste. #104
Palm Beach Gardens, FL 33410-4349
Mailing address
30 Azalea Dr
Riviera Beach, FL 33404-3041
Phone (561) 882-4214
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA47294 | Other | FL | MASSAGE THERAPY LICENSE |
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 |
|---|---|---|---|
| MA47294 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386754166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 AZALEA DR",
"city": "RIVIERA BEACH",
"state": "FL",
"postal_code": "334043041",
"telephone_number": "561-882-4214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3375 BURNS RD",
"address_2": "STE. #104",
"city": "PALM BEACH GARDENS",
"state": "FL",
"postal_code": "334104349",
"telephone_number": "561-624-1719",
"fax_number": "561-625-0768"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELLISSIMO",
"first_name": "MICHELE",
"middle_name": "ROSE",
"credential": "L.M.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "MA47294",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSAGE THERAPY LICENSE",
"identifier": "MA47294",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palm Beach Gardens, FL
Sources for this page
- 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.