Active NPI
Omar Nodarse, MA
- Massage Therapist
- Miami Gardens, FL
National Provider Identifier
1386949451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA60754
- Practice address
- 5190 NW 167TH St
Miami Gardens, FL 33014-6328 - Phone
- (305) 625-7719
- Fax
- (305) 625-7720
- NPI assigned
- Jan 20, 2011
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA60754 | FL | Primary |
Addresses
Primary practice location
5190 NW 167TH St
Miami Gardens, FL 33014-6328
Mailing address
445 E 47TH St
Hialeah, FL 33013-1863
Phone (786) 470-4620
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA60754 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295481600000",
"number": "1386949451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "445 E 47TH ST",
"city": "HIALEAH",
"state": "FL",
"postal_code": "330131863",
"telephone_number": "786-470-4620",
"fax_number": "305-625-7720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5190 NW 167TH ST",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "330146328",
"telephone_number": "305-625-7719",
"fax_number": "305-625-7720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NODARSE",
"first_name": "OMAR",
"name_prefix": "Mr.",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-01-20",
"last_updated": "2011-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA60754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.