Individual provider Active NPI

Alexei Marquez Fabre

  • Massage Therapist
  • Jacksonville, FL
National Provider Identifier
1679256580
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA100474 Issued in FL
Practice address
9250 Cypress Green Dr Ste 101
Jacksonville, FL 32256-5514
Phone
(904) 422-4765
NPI assigned
Aug 8, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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 MA100474 FL Primary

Addresses

Primary practice location

9250 Cypress Green Dr Ste 101
Jacksonville, FL 32256-5514

Mailing address

6005 Gumwood Dr
Jacksonville, FL 32277-1655
Phone (904) 422-4765

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
MA100474FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1679256580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 GUMWOOD DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322771655",
            "telephone_number": "904-422-4765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 CYPRESS GREEN DR STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322565514",
            "telephone_number": "904-422-4765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARQUEZ FABRE",
        "first_name": "ALEXEI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA100474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; 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.