CRYSTAL CLARK (NPI# 1619581311) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619581311 |
| Entity Type | Individual |
| Full Name | CRYSTAL CLARK |
| Credential | LMT |
| Practice Address |
12506 Ne 4th Ave Apt 101 North Miami FL 33161-4668 |
| Practice Telephone | 3057142159 |
| Mailing Telephone | 3057142159 |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2020-09-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA83036 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366068470 | Crystal Sherase Clark | Technician | 4429 Grant St Ne, Washington, DC 20019-4739 | 2020-06-24 |
| 1467014894 | Crystal Clark | Chore Provider | 153 Brambury Dr Apt D, Rochester, NY 14621-1820 | 2019-07-06 |
| 1386112050 | Crystal Lynn Clark | Internal Medicine | 12056 224th St, Cambria Heights, NY 11411-2141 | 2018-11-11 |
| 1154898179 | Crystal B Clark | Family Medicine | 112 Woodland Drive, Lancaster, SC 29720 | 2018-10-29 |
| 1801259619 | Crystal Clark | Technician, Other | 3400 State St # 750, Salem, OR 97301-5861 | 2016-03-30 |
| 1467829911 | Crystal Lynn Clark | Specialist/Technologist | 1500 Manley St, Dalton High School, Dalton, GA 30720-4088 | 2015-08-31 |
| 1386073070 | Crystal Shawn Clark | Nurse Anesthetist, Certified Registered | 240 W Sugar Loaf Rd, Tucson, AZ 85737-3756 | 2013-11-04 |
| 1417391160 | Crystal Joan Clark | Nurse Practitioner | 11930 Arbor St Ste 200, Omaha, NE 68144-2998 | 2013-04-24 |
| 1952677700 | Crystal Nache Clark | Counselor | 13902 Sage Thrasher Lane, Riverview, FL 33579 | 2012-03-27 |
| 1639443658 | Crystal A Clark | Chore Provider | 331 Jamestown Ct, Columbus, OH 43228-4030 | 2012-03-08 |
| Street Address |
12506 NE 4TH AVE APT 101 |
| City | NORTH MIAMI |
| State | FL |
| Zip Code | 33161-4668 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609365907 | Silvia Maria Sanchez Del Campo | General Practice | 412-436 Ne 125th St, North Miami, FL 33161 | 2018-05-02 |
| 1841718806 | Christina Collier | Student in an Organized Health Care Education/Training Program | 12046 Ne 16th Ave, Apt. 5105, Miami, FL 33161 | 2017-08-30 |
| 1477076768 | Mariline Suit | Assisted Living Facility | 960 Ne 136 Street, North Miami, FL 33161 | 2017-07-19 |
| 1588186910 | Virtuous Care & Staffing, Inc. | In Home Supportive Care | 1525 Ne 136th Street, Miami, FL 33161 | 2017-07-07 |
| 1881043222 | Elitane Rinville | Counselor | 11422 Ne 13 Ave., Miami, FL 33161 | 2016-06-07 |
| 1992183529 | India Bass | Counselor | 12635 Ne Miami Ct, North Miami, FL 33161 | 2015-05-14 |
| 1659775781 | Loralei Ann Magadia Parchejo | Pharmacy Technician | 173 Ne 108th St, Miami Shores, FL 33161 | 2014-10-17 |
| 1912307513 | Louise Marjori Paul | Nurse Practitioner | 1190 N.w. 125th Street, Chen Medical North Miami (125th), North Miami, FL 33161 | 2014-09-02 |
| 1598185860 | Institute of Wholistic Empowerment | Counselor | 1065 Ne 125 Street, Suite 317a, North Miami, FL 33161 | 2014-04-24 |
| 1689095689 | Sandra Batista | Counselor | 11031 Ne 6th Avenue, Miami, FL 33161 | 2013-12-18 |
| Find all providers in zip 33161 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669974952 | Michie Antonia Alvaro | Massage Therapist | 10820 Ne 11th Ct, North Miami, FL 33161-7310 | 2018-03-02 |
| 1912415639 | Orlando R Guirado Sr. | Massage Therapist | 14322 Ne 18th Ave, North Miami, FL 33181-1402 | 2018-01-16 |
| 1114237831 | Quantum Theraptutics, Inc. | Massage Therapist | 640 Ne 124 St, North Miami, FL 33161 | 2010-10-15 |
| 1144530072 | Lucy Hidalgo | Massage Therapist | 2138 N.e 123 Street, Esencia Day Spa, North Miami, FL 33181 | 2010-10-13 |
| 1770896383 | Sabine Dessources | Massage Therapist | 365 Nw 129th St, North Miami, FL 33168-3701 | 2010-07-24 |
| 1689903874 | Monica S Steffens | Massage Therapist | 1855 Ne 121st St, North Miami, FL 33181-2858 | 2009-12-16 |
| 1356594006 | Mela Therapeutics, Inc. | Massage Therapist | 20754 West Dixie Hwy, North Miami, FL 33180 | 2008-10-28 |
| 1821278243 | Alex Corgelas | Massage Therapist | 1285 Ne 137th Ter, North Miami, FL 33161-3420 | 2007-11-14 |
| 1184814121 | Gennadiy Zelfman | Massage Therapist | 13220 Biscayne Blvd, North Miami, FL 33181-2040 | 2007-07-26 |
| 1316955685 | Susan Baran Blumin | Massage Therapist | 1948 Ne 123rd St Ste 107, North Miami, FL 33181-2800 | 2006-08-03 |
| Find all providers in NORTH MIAMI | ||||
| City | NORTH MIAMI |
| Zip Code | 33161 |
Please comment or provide details below to improve the information on CRYSTAL CLARK.
| 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.