Le Camelot LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA005943 Issued in FL

Legal business name

LE CAMELOT LLC

Practice address

19923 Jodi Dr
Lutz, FL 33558-5005

Phone

(813) 774-4475

Fax

(813) 435-2001

NPI assigned

Jul 21, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Sandra Brooks Soule, LMT

Title

LMT/Owner

Phone

(813) 774-4475

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Le Camelot Wellness Spa Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sandra Brooks, MPH, LMT

  • Massage Therapist
  • Lutz, FL
  • NPI 1285961037
  NPD (past)

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

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311206400000",
    "number": "1831487032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19923 JODI DR",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335585005",
            "telephone_number": "813-774-4475",
            "fax_number": "813-435-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19923 JODI DR",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335585005",
            "telephone_number": "813-774-4475",
            "fax_number": "813-435-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LE CAMELOT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-21",
        "last_updated": "2011-07-21",
        "status": "A",
        "authorized_official_last_name": "SOULE",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "BROOKS",
        "authorized_official_title_or_position": "LMT/OWNER",
        "authorized_official_telephone_number": "813-774-4475",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA005943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1285961037",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9566677",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Le Camelot Wellness Spa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Beth Ann M Leaf, P.A.
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• Kristi Lee, CAA
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• Massage Therapist in Lutz, FL
• Providers in Lutz, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.

Verify at the official NPI Registry.