Active NPI
Joe Maruca, L.M.T.
- Specialist
- Gainesville, FL
National Provider Identifier
1457655391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA00002884
- Practice address
- 4340 NW 46TH Ter
Gainesville, FL 32606-4339 - Phone
- (352) 336-1661
- Fax
- (352) 336-3099
- NPI assigned
- Jan 7, 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 |
|---|---|---|---|---|
| Specialist | 174400000X | MA00002884 | FL | Primary |
Addresses
Primary practice location
4340 NW 46TH Ter
Gainesville, FL 32606-4339
Mailing address
4340 NW 46TH Ter
Gainesville, FL 32606-4339
Phone (352) 336-1661
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C5289 | Other | FL | BCBS PROVIDER NUMBER |
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 |
|---|---|---|---|
| MA00002884 | FL | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294358400000",
"number": "1457655391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4340 NW 46TH TER",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326064339",
"telephone_number": "352-336-1661",
"fax_number": "352-336-3099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4340 NW 46TH TER",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326064339",
"telephone_number": "352-336-1661",
"fax_number": "352-336-3099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARUCA",
"first_name": "JOE",
"name_prefix": "Mr.",
"credential": "L.M.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-01-07",
"last_updated": "2011-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "FL",
"license": "MA00002884",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "C5289",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.