New Life Myofascial Release, LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

NEW LIFE MYOFASCIAL RELEASE, LLC

Practice address

2101 W State St
Tampa, FL 33606-1047

Phone

(813) 461-4171

NPI assigned

Feb 26, 2020

Organization subpart

No

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

Authorized official

Name

Jennifer L Glass, OTR/L

Title

Owner

Phone

(941) 773-7620

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Jennifer L Lind, OTR/L

  • Occupational Therapist
  • Tampa, FL
  • NPI 1477855211
  NPD

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582675200000",
    "number": "1962036228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 W STATE ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336061047",
            "telephone_number": "813-461-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 W STATE ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336061047",
            "telephone_number": "813-461-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LIFE MYOFASCIAL RELEASE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-26",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A",
        "authorized_official_last_name": "GLASS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-773-7620",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477855211",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• New Horizons Pediatrics Inc
• New Imaging Center, Inc
• New Leaf Chiropractic Wellness Center, LLC
• New Leaf Psychological Services, LLC
• New Life and Rehabilitation Center LLC
• New Life Obstetrical Care Inc
• New Life Psychology and Coaching LLC
• New Life Rehab Center LLC
• New Lung Associates PA
• New Moon Services

• Occupational Therapist in Tampa, FL
• Providers in Tampa, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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.