INTEGRA THERAPEUTIC MASSAGE, LLC (NPI# 1376159178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376159178 |
| Entity Type | Organization |
| Organization Name | INTEGRA THERAPEUTIC MASSAGE, LLC |
| Practice Address |
1871 Wells Rd Ste 300 Orange Park FL 32073-2350 |
| Mailing Address |
8257 Seven Mile Dr Ponte Vedra Beach FL 32082-3132 |
| Practice Telephone | 9046124588 |
| Practice Fax Number | 9042603011 |
| Mailing Telephone | 9046124588 |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-18 |
| Authorized Official Name | MS. DARLENE TAN (ADMINISTRATOR) |
| Authorized Official Telephone | 9046124588 |
| Authorized Official Credential | ESQ |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 1174800221 | 05 | |
| FL | 1285070532 | 05 | |
| FL | STATE OF FLORIDA DEPARTMENT OF HEALTH | PTA27875 | 01 |
| FL | STATE OF FLORIDA DEPARTMENT OF HEALTH | PT6934 | 01 |
| FL | STATE OF FLORIDA DEPARTMENT OF HEALTH | PT8535 | 01 |
| FL | STATE OF FLORIDA DEPARTMENT OF HEALTH | PT10897 | 01 |
| Other Name | Type Code |
|---|---|
| INTEGRA PHYSICAL THERAPY AND MASSAGE | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2425 Dunn Ave Ste 1, Jacksonville, FL 322184603 | 9046124588 | 9042604849 |
| 6144 Gazebo Park Pl S Ste 101, Jacksonville, FL 322571086 | 9046124588 | 9042604849 |
| Street Address |
1871 WELLS RD STE 300 |
| City | ORANGE PARK |
| State | FL |
| Zip Code | 32073-2350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
| 1962028688 | Esra Sari | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue., Orange Park Medical Center, Orange Park, FL 32073 | 2020-06-18 |
| 1104441146 | Zeshan Tariq Malik | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue, Office of Graduate Medical Educa, Orange Park, FL 32073 | 2020-06-16 |
| 1902421894 | Ameer Hamza | Student in an Organized Health Care Education/Training Program | 2001, Kingsley Avenue Office of Graduate Medical Educat, Orange Park, FL 32073 | 2020-06-16 |
| 1497378103 | Fawad Ahmed Rashid | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue Office of Graduate Medical Educati, Orange Park, FL 32073 | 2020-05-28 |
| 1477174985 | Hannan Asghar | Student in an Organized Health Care Education/Training Program | Office of Graduate Medical Education 2001 Kingsley, Orange Park, FL 32073 | 2020-05-06 |
| 1902427156 | Emmanuel Iyanuloluwa Morakinyo | Student in an Organized Health Care Education/Training Program | 413 Deer View Avenue, 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
| 1437799327 | Dalande Leger | Behavior Technician | 1563 Kingsley Ave Suite 103, Orange Park, FL 32073 | 2020-01-08 |
| 1215598313 | Mohammad Harisullah Khan | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Gme Office, Orange Park, FL 32073 | 2019-06-28 |
| 1558927970 | Preetha Kamath | Student in an Organized Health Care Education/Training Program | Orange Park Medical Center, 2001 Kingsley Ave, Orange Park, FL 32073 | 2019-05-10 |
| Find all providers in zip 32073 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679197420 | Smart Moves Physiotherapy, LLC | Clinic/Center | 784 Blanding Blvd Ste 106, Orange Park, FL 32065-7724 | 2020-06-07 |
| 1386618064 | Physical Therapy & Rehabilitation Clinic Inc | Clinic/Center | 2140 Kingsley Ave, Suite 5, Orange Park, FL 32073-5180 | 2006-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356942742 | Restore Pelvic Health & Rehab LLC | Clinic/Center | 301 E Yamato Rd Ste 1240, Boca Raton, FL 33431-4931 | 2020-11-03 |
| 1558962019 | Ldg Medical Center LLC | Clinic/Center | 4485 Stirling Rd, Davie, FL 33314-7517 | 2020-11-02 |
| 1255930855 | Tideline Sports Performance & Rehabilitation LLC | Clinic/Center | 5261 Paylor Ln, Lakewood Ranch, FL 34240-2203 | 2020-10-23 |
| 1578162780 | Fourth Trimester Wellness LLC | Clinic/Center | 711 Chancellar Dr, Lutz, FL 33548-4512 | 2020-10-19 |
| 1306445754 | Concierge Rehab Inc | Clinic/Center | 1045 E Heritage Club Cir, Delray Beach, FL 33483-3483 | 2020-10-17 |
| 1689272627 | Ucdm Services Inc | Clinic/Center | 12030 Sw 129th Ct Ste 103, Miami, FL 33186-4584 | 2020-10-12 |
| 1902404163 | Frontline Physical Therapy | Clinic/Center | 8655 Bayou Way N, Pinellas Park, FL 33782-4549 | 2020-10-11 |
| 1891393138 | Venice Physical Therapy and Sports Medicine | Clinic/Center | 1776 S Tamiami Trl, Venice, FL 34293-1602 | 2020-10-09 |
| 1750988812 | Angeles Medical Center,inc. | Clinic/Center | 8725 Nw 18th Ter Ste 403, Doral, FL 33172-2610 | 2020-10-02 |
| 1740887967 | Neuro Thrive LLC | Clinic/Center | 1963 Ne Felicita Pl, Jensen Beach, FL 34957-5756 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
| City | ORANGE PARK |
| Zip Code | 32073 |
Please comment or provide details below to improve the information on INTEGRA THERAPEUTIC MASSAGE, LLC.
| 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.