Individual provider Active NPI

Michel Reyes, MASSAGE THERAPY

  • Rehabilitation Practitioner
  • Tampa, FL
National Provider Identifier
1386855278
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
MA 44756 Issued in FL
Practice address
15105 Monet Dr
Tampa, FL 33613-1209
Phone
(813) 476-3102
NPI assigned
May 24, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 9667060 FL
Rehabilitation Practitioner 225400000X MA 44756 FL Primary

Addresses

Primary practice location

15105 Monet Dr
Tampa, FL 33613-1209

Mailing address

15105 Monet Dr
Tampa, FL 33613-1209
Phone (813) 476-3102

Other practice location 1

1004 W Linebaugh Ave Ste A
Tampa, FL 33612-7837
Phone (813) 443-5370

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

LicenseStateTypeSpecialty
9667060FLMDRegistered Nurse
MA 44756FLMDRehabilitation Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Wellness Center LLC Single Specialty CurrentSince Oct 24, 2021 Accepting new patients
Massage on the Spot Past Accepting new patients

Locations

1004 W Linebaugh Ave
Ste A
Tampa, FL 33612
Phone (813) 443-5370

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1386855278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15105 MONET DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131209",
            "telephone_number": "813-476-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15105 MONET DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131209",
            "telephone_number": "813-476-3102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1004 W Linebaugh Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336127837",
            "country_code": "US",
            "telephone_number": "813-443-5370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYES",
        "first_name": "MICHEL",
        "name_prefix": "Mr.",
        "credential": "MASSAGE THERAPY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9667060",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "FL",
            "license": "MA 44756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.