Individual provider Active NPI

Alla Alexandrovna Nazarova

  • Massage Therapist
  • Jacksonville, FL
National Provider Identifier
1912855230
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA88987 Issued in FL
Practice address
4480 Deerwood Lake Pkwy Unit 258
Jacksonville, FL 32216-2262
Phone
(904) 206-3995
NPI assigned
Mar 20, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X MA88987 FL Primary

Addresses

Primary practice location

4480 Deerwood Lake Pkwy Unit 258
Jacksonville, FL 32216-2262

Mailing address

4480 Deerwood Lake Pkwy Unit 258
Jacksonville, FL 32216-2262
Phone (904) 206-3995

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
MA88987FLMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1773964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1912855230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4480 DEERWOOD LAKE PKWY UNIT 258",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322162262",
            "telephone_number": "904-206-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4480 DEERWOOD LAKE PKWY UNIT 258",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322162262",
            "telephone_number": "904-206-3995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZAROVA",
        "first_name": "ALLA",
        "middle_name": "ALEXANDROVNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-03-20",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA88987",
            "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 Mar 20, 2026; 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.