Active NPI
Marena Collazo-Lugo
- Massage Therapist
- Jacksonville, FL
National Provider Identifier
1689411050
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA100417
- Practice address
- 4237 Salisbury Rd
Building 1, Suite 107
Jacksonville, FL 32216 - Phone
- (305) 975-5454
- NPI assigned
- Jul 11, 2024
- 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 | MA100417 | FL | Primary |
Addresses
Primary practice location
4237 Salisbury Rd
Building 1, Suite 107
Jacksonville, FL 32216
Mailing address
2619 College St Apt 5
Jacksonville, FL 32204-3539
Phone (305) 975-5454
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 |
|---|---|---|---|
| MA100417 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720656000000",
"number": "1689411050",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2619 COLLEGE ST APT 5",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322043539",
"telephone_number": "305-975-5454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4237 SALISBURY RD",
"address_2": "BUILDING 1, SUITE 107",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32216",
"telephone_number": "305-975-5454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLAZO-LUGO",
"first_name": "MARENA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-11",
"last_updated": "2024-07-11",
"certification_date": "2024-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA100417",
"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 Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.