Active NPI
Luis Gullermo Pelaez, LMT
- Reflexologist
- Tampa, FL
National Provider Identifier
1760772461
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Reflexologist
- License
- MA62313
- Practice address
- 8107 Canterbury Lake Blvd
Tampa, FL 33619-6681 - Phone
- (813) 374-9142
- NPI assigned
- Apr 14, 2011
- Last updated
- Apr 14, 2011
- 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 |
|---|---|---|---|---|
| Reflexologist | 173C00000X | MA62313 | FL | Primary |
Addresses
Primary practice location
8107 Canterbury Lake Blvd
Tampa, FL 33619-6681
Mailing address
8107 Canterbury Lake Blvd
Tampa, FL 33619-6681
Phone (813) 374-9142
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA62313 | Other | FL | LICENSED MASSAGE THERAPIST |
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 |
|---|---|---|---|
| MA62313 | FL | MD | Reflexologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302739200000",
"number": "1760772461",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8107 CANTERBURY LAKE BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336196681",
"telephone_number": "813-374-9142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8107 CANTERBURY LAKE BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336196681",
"telephone_number": "813-374-9142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELAEZ",
"first_name": "LUIS",
"middle_name": "GULLERMO",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-14",
"last_updated": "2011-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "173C00000X",
"taxonomy_group": "",
"desc": "Reflexologist",
"state": "FL",
"license": "MA62313",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED MASSAGE THERAPIST",
"identifier": "MA62313",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.