Active NPI
Roy Alexander Llera, LMT
- Massage Therapist
- Melbourne, FL
National Provider Identifier
1639412182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA57119
- Practice address
- 18 W Avenue B
Suite 2
Melbourne, FL 32901-1219 - Phone
- (321) 634-2067
- NPI assigned
- Apr 3, 2013
- 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 | MA57119 | FL | Primary |
Addresses
Primary practice location
18 W Avenue B
Suite 2
Melbourne, FL 32901-1219
Mailing address
249 Certosa Ave NE
Palm Bay, FL 32907-3228
Phone (321) 634-2067
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 |
|---|---|---|---|
| MA57119 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364947200000",
"number": "1639412182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "249 CERTOSA AVE NE",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329073228",
"telephone_number": "321-634-2067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 W AVENUE B",
"address_2": "SUITE 2",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329011219",
"telephone_number": "321-634-2067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LLERA",
"first_name": "ROY",
"middle_name": "ALEXANDER",
"name_prefix": "Mr.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-04-03",
"last_updated": "2013-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA57119",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.