Active NPI
Kyryl Rutman
- Massage Therapist
- Wilton Manors, FL
National Provider Identifier
1851252480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MA104030
- Practice address
- 2208 NE 11TH Ave
Wilton Manors, FL 33305-2214 - Phone
- (954) 567-9340
- NPI assigned
- Nov 21, 2025
- Last updated
- Nov 21, 2025
- Sex
- Male
- Sole proprietor
- No
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 | MA104030 | FL | Primary |
Addresses
Primary practice location
2208 NE 11TH Ave
Wilton Manors, FL 33305-2214
Mailing address
6019 Bayview Dr
Fort Lauderdale, FL 33308-2229
Phone (407) 925-7084
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 |
|---|---|---|---|
| MA104030 | FL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1763683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763683200000",
"number": "1851252480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6019 BAYVIEW DR",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333082229",
"telephone_number": "407-925-7084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2208 NE 11TH AVE",
"city": "WILTON MANORS",
"state": "FL",
"postal_code": "333052214",
"telephone_number": "954-567-9340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUTMAN",
"first_name": "KYRYL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-11-21",
"last_updated": "2025-11-21",
"certification_date": "2025-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "FL",
"license": "MA104030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilton Manors, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.