Active NPI
Karen Roscela Manubag De Mesa, R.P.T.
- Pain Clinic/Center
- Coral Springs, FL
National Provider Identifier
1639400955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Clinic/Center
- License
- 18925
- Practice address
- 6020 W Sample Rd
Apt 101
Coral Springs, FL 33067-3261 - Phone
- (954) 752-6188
- NPI assigned
- Jan 26, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pain Clinic/Center | 261QP3300X | 18925 | MA | Primary |
Addresses
Primary practice location
6020 W Sample Rd
Apt 101
Coral Springs, FL 33067-3261
Mailing address
6020 W Sample Rd
Coral Springs, FL 33067-3261
Phone (954) 752-6188
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 |
|---|---|---|---|
| 18925 | MA | MD | Pain Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1264464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264464000000",
"number": "1639400955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6020 W SAMPLE RD",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330673261",
"telephone_number": "954-752-6188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6020 W SAMPLE RD",
"address_2": "APT 101",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330673261",
"telephone_number": "954-752-6188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE MESA",
"first_name": "KAREN ROSCELA",
"middle_name": "MANUBAG",
"name_prefix": "Mrs.",
"credential": "R.P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-26",
"last_updated": "2010-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "261QP3300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Pain",
"state": "MA",
"license": "18925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coral Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.