Active NPI
Rita Ellen Vidur, LMT
- Massage Therapist
- Davie, FL
National Provider Identifier
1669807293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA73051
- Practice address
- 2883 S University Dr
Davie, FL 33328-1440 - Phone
- (954) 424-0055
- NPI assigned
- Sep 13, 2013
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA73051 | FL | Primary |
Addresses
Primary practice location
2883 S University Dr
Davie, FL 33328-1440
Mailing address
436 Tamarind Dr
Hallandale Beach, FL 33009-6542
Phone (954) 629-9479
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 |
|---|---|---|---|
| MA73051 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379030400000",
"number": "1669807293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "436 TAMARIND DR",
"city": "HALLANDALE BEACH",
"state": "FL",
"postal_code": "330096542",
"telephone_number": "954-629-9479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2883 S UNIVERSITY DR",
"city": "DAVIE",
"state": "FL",
"postal_code": "333281440",
"telephone_number": "954-424-0055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIDUR",
"first_name": "RITA",
"middle_name": "ELLEN",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-13",
"last_updated": "2013-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA73051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.