SPA BLU (NPI# 1063656791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063656791 |
| Entity Type | Organization |
| Organization Name | SPA BLU |
| Other Organization Name | SPA BLU, INC. |
| Practice Address |
57 Uptown Grayton Cir Ste A Santa Rosa Beach FL 32459-8814 |
| Mailing Address |
57 A Uptown Grayton Circle Grayton Beach FL 32459 |
| Practice Telephone | 8502315784 |
| Practice Fax Number | 8502314718 |
| Mailing Telephone | 8502315784 |
| Mailing Fax Number | 8502314718 |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2009-04-24 |
| Authorized Official Name | KRISTA DUMBLETON (OWNER/LMT) |
| Authorized Official Telephone | 8502315784 |
| Authorized Official Credential | LMT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | MM16325 | FL | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Spa Blu, Inc. | Former Legal Business Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | SPA BLUE 4 AVENUE CORP. | 125 4th Avenue, New York, New York 10003 |
| Street Address |
57 UPTOWN GRAYTON CIR STE A |
| City | SANTA ROSA BEACH |
| State | FL |
| Zip Code | 32459-8814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457681256 | Christopher Cole Blair | Massage Therapist | 57 Uptown Grayton Cir Ste A, Santa Rosa Beach, FL 32459-8814 | 2009-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336740521 | Gary Mcfadyen | Hearing Instrument Specialist | 395 E. Point Washington, Santa Rosa Beach, FL 32459 | 2020-11-04 |
| 1235783218 | Camilla Ruth Chacon | Nurse Practitioner | 4821 Highway 98 West, Suite 104, Santa Rosa Beach, FL 32459 | 2019-07-29 |
| 1942797287 | Lauren Mank | Assistant Behavior Analyst | 67 Hiker St Fl 32459, Santa Rosa Beach, FL 32459 | 2018-04-20 |
| 1740781137 | Imaging Institute LLC | Radiology | 6757 Us Hwy 98 W Ste 301, Santa Rosa Beach, FL 32459 | 2018-02-22 |
| 1023540648 | Emerald Coast Medical Supplies LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 48 Bald Eagle Dr, Santa Rosa Beach, FL 32459 | 2017-04-02 |
| 1215485230 | Tamra Snook | Social Worker | 156 N County Highway 393 Unit 1, Santa Rosa Beach, FL 32459 | 2016-09-19 |
| 1437605730 | Alexandra Armstrong | Physical Therapist | 249 Mack Bayou Loop Ste 101, Santa Rosa Beach, FL 32459 | 2016-08-28 |
| 1386097749 | Itetra Smith | Behavior Technician | 67 Hiker St, Santa Rosa Beach, FL 32459 | 2016-07-20 |
| 1730527086 | Emerald Coast Medical Supplies LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 48 Bald Eagle Drive, Santa Rosa Beach, FL 32459 | 2013-06-10 |
| 1114269768 | Pamela Jean Skaff | Dentist | 101 Lecom Way, Defuniak Springs, FL 32459 | 2013-03-21 |
| Find all providers in zip 32459 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770949893 | Steven Weiner | Specialist | 2050 W County Highway 30a, Suite 114, Santa Rosa Beach, FL 32459-0187 | 2016-01-05 |
| 1699945170 | Women & Children First, LLC | Specialist | 31 E Mack Bayou Dr, Santa Rosa Beach, FL 32459-7102 | 2008-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437758893 | Ursula Olazabal | Specialist | 402 N Babcock St Ste 101, Melbourne, FL 32935-7335 | 2020-10-18 |
| 1043818529 | Michele Rosenthal | Specialist | 425 Greenwich Circle, #107, Jupiter, FL 33458-4809 | 2020-10-15 |
| 1184230096 | Lauren Daisey Woodruff | Specialist | 4440 Nelson Ave, Sarasota, FL 34231-7515 | 2020-09-17 |
| 1699385823 | Suzanne Denise Moe | Specialist | 48 Nw 4th St, Homestead, FL 33030-5942 | 2020-08-03 |
| 1437768033 | Coastal Injury Clinic LLC | Specialist | 2700 Riverside Ave Ste 1, Jacksonville, FL 32205-8233 | 2020-07-29 |
| 1417566712 | Angela Berry Williams | Specialist | 5175 W Atlantic Ave Ste C, Delray Beach, FL 33484-8101 | 2020-07-23 |
| 1255957643 | Rhonda D Smith Roberts | Specialist | 2754 Sam Hardwick Blvd, Jacksonville, FL 32246-3892 | 2020-06-22 |
| 1316562911 | A School 4 Legends LLC | Specialist | 11565 Se 57th Ct, Belleview, FL 34420-4361 | 2020-06-10 |
| 1700400397 | Juda Mclaren | Specialist | 7360 Beacon Hill Loop Apt 8, Orlando, FL 32818-6431 | 2020-05-30 |
| 1811518384 | Lori Rubin | Specialist | 8181 W Broward Blvd Ste 204, Plantation, FL 33324-2049 | 2020-05-06 |
| Find all providers with the same taxonomy | ||||
| City | SANTA ROSA BEACH |
| Zip Code | 32459 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.