Muddy Mantra LLC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Legal business name

MUDDY MANTRA LLC

Practice address

3460 Tampa Rd
Palm Harbor, FL 34684-3530

Phone

(727) 422-3954

NPI assigned

Sep 10, 2021

Last updated

Sep 21, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melodie Lee Moreno, ERYT-500 YCAEPNPI 1306515598

Title

Manager

Phone

(727) 422-3954

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Melodie Lee Moreno, ERYT-500

  • Specialist
  • Palm Harbor, FL
  • NPI 1306515598
  NPD Authorized official

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632182400000",
    "number": "1538838628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3460 TAMPA RD",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843530",
            "telephone_number": "727-422-3954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 TAMPA RD",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843530",
            "telephone_number": "727-422-3954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUDDY MANTRA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A",
        "authorized_official_last_name": "MORENO",
        "authorized_official_first_name": "MELODIE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "727-422-3954",
        "authorized_official_credential": "ERYT-500 YCAEP"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shianne Moss
• Christina Moustopoulos, OD
• Movement Chiropractic & Wellness LLC
• MRI Associates of Palm Harbor, Inc (Palm Harbor MRI)
• Kimberly Mudano, PT
• Christine Muenks
• Allison Mulbarger
• Pamela Ann Mullenbruck
• Kelly Marie Mullikin, PA-C
• Multimedia Designs Inc.

• Athletic Trainer in Palm Harbor, FL
• Providers in Palm Harbor, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.