Serenity Health Spa, LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

L08000106026 Issued in FL

Legal business name

SERENITY HEALTH SPA, LLC

Practice address

2295 S Hiawassee Rd
Suite 209
Orlando, FL 32835-8746

Phone

(407) 678-7100

Fax

(407) 678-7200

NPI assigned

Nov 24, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Clint L Johnson

Title

Owner

Phone

(407) 678-7100

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1227484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227484800000",
    "number": "1932354537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2295 S HIAWASSEE RD",
            "address_2": "SUITE 209",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328358746",
            "telephone_number": "407-678-7100",
            "fax_number": "407-678-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 S HIAWASSEE RD",
            "address_2": "SUITE 209",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328358746",
            "telephone_number": "407-678-7100",
            "fax_number": "407-678-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HEALTH SPA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-24",
        "last_updated": "2008-11-24",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CLINT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-678-7100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "L08000106026",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "L08000106026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Orlando, FL
• Providers in Orlando, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2008; 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.