Individual provider Active NPI

Dustin Espinosa, LMT

  • Massage Therapist
  • Jacksonville, FL
National Provider Identifier
1790517183
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA102042 Issued in FL
Practice address
9785 Crosshill Blvd Ste 108
Jacksonville, FL 32222-5889
Phone
(904) 772-6522
NPI assigned
Aug 15, 2024
Last updated
Aug 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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 MA102042 FL Primary

Addresses

Primary practice location

9785 Crosshill Blvd Ste 108
Jacksonville, FL 32222-5889

Mailing address

9785 Crosshill Blvd Ste 108
Jacksonville, FL 32222-5889
Phone (904) 772-6522

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
MA102042FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1790517183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9785 CROSSHILL BLVD STE 108",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322225889",
            "telephone_number": "904-772-6522",
            "fax_number": "904-772-6553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9785 CROSSHILL BLVD STE 108",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322225889",
            "telephone_number": "904-772-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPINOSA",
        "first_name": "DUSTIN",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA102042",
            "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 15, 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.

Verify at the official NPI Registry.