Individual provider Active NPI

Yassel Quijano, LMT

  • Massage Therapist
  • Tampa, FL
National Provider Identifier
1639313281
Registry record updated Apr 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA 53711 Issued in FL
Practice address
3550 W Waters Ave Ste 108
Tampa, FL 33614-2767
Phone
(813) 374-9218
Fax
(813) 374-9221
NPI assigned
Apr 27, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA 53711 FL Primary

Addresses

Primary practice location

3550 W Waters Ave Ste 108
Tampa, FL 33614-2767

Mailing address

3550 W Waters Ave Ste 108
Tampa, FL 33614-2767
Phone (813) 374-9218

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
MA 53711FLMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
West Waters Medical Center, LLC Past Accepting new patients

Organizations & group practices 1

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": "1240790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240790400000",
    "number": "1639313281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 W WATERS AVE STE 108",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142767",
            "telephone_number": "813-374-9218",
            "fax_number": "813-374-9221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 W WATERS AVE STE 108",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142767",
            "telephone_number": "813-374-9218",
            "fax_number": "813-374-9221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIJANO",
        "first_name": "YASSEL",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-27",
        "last_updated": "2009-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA 53711",
            "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 Apr 27, 2009; 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.