MEDSPORTS PROMASSAGE (NPI# 1932475167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932475167 |
| Entity Type | Organization |
| Organization Name | MEDSPORTS PROMASSAGE |
| Practice Address |
3491 Pall Mall Dr Suite 104 Jacksonville FL 32257-5449 |
| Mailing Address |
Po Box 8565 Fleming Island FL 32006-0014 |
| Practice Telephone | 9045050575 |
| Mailing Telephone | 9045050575 |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2012-04-02 |
| Authorized Official Name | MONIQUE COLEMAN HAMID (OWNER) |
| Authorized Official Telephone | 9045050575 |
| Authorized Official Credential | LMT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | MA36322 | FL | Managed Care Organizations |
| Street Address |
3491 PALL MALL DR SUITE 104 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32257-5449 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669652228 | Monique Coleman Hamid | Massage Therapist | 3491 Pall Mall Dr, Suite 104, Jacksonville, FL 32257-5449 | 2007-11-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740835842 | Majdoline Kasera | Pharmacist | 11250-4 Old St Augustine Rd, Jacksonville, FL 32257 | 2019-08-06 |
| 1386203859 | Jetaime Y Lewis | Physical Therapist | 9765 San Jose Blvd Ste 6, Jacksonville, FL 32257 | 2019-06-10 |
| 1437622107 | Michelle Espanol Garcia | Nurse Practitioner | 9957 Moorings Dr Ste 204, Jacksonville, FL 32257 | 2019-01-05 |
| 1982172995 | Pacifica Augustine Road LLC | Alzheimer Center (Dementia Center) | 10660 Old Augustine Road, Jacksonville, FL 32257 | 2018-11-07 |
| 1659860492 | Andrea Leigh Miller | Social Worker | 10416 Spotted Fawn Lane, Jacksonville, FL 32257 | 2018-05-08 |
| 1376049965 | Stephanie Lynne Jordon | Nurse Practitioner | 9765 San Jose Blvd Ste 102, Jacksonville, FL 32257 | 2018-04-02 |
| 1205335619 | Annetta Aileen Brown | Respite Care | 4901 Sunbeam Rd Apt 1016, Jacksonville, FL 32257 | 2018-02-12 |
| 1841714888 | Freda Stevens | Counselor | 9521 Shellie Road Unit 13, Jacksonville, FL 32257 | 2017-08-01 |
| 1659821353 | Jennifer Lavoro | Acupuncturist | 11259 Thomaston Pl, Jacksonville, FL 32257 | 2016-10-06 |
| 1225488232 | Avenues Dental LLC | Dentist | 6144 Gazebo Park Place South, Ste 210, Jacksonville, FL 32257 | 2016-06-21 |
| Find all providers in zip 32257 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891188173 | Julington Creek Pediatrics | Preferred Provider Organization | 774 State Road 13 Ste 6, Jacksonville, FL 32259-3815 | 2015-03-11 |
| 1760881163 | First Coast Medical Associates LLC | Preferred Provider Organization | 13241 Bartram Park Blvd Unit 413, Jacksonville, FL 32258-5237 | 2014-08-21 |
| 1891031910 | Mandarin Family Medicine, P.a. | Preferred Provider Organization | 12276-210 San Jose Blvd, Jacksonville, FL 32223 | 2012-12-18 |
| 1124195573 | Lakeshore Medical Care Center, Inc | Preferred Provider Organization | 4616 San Juan Ave, Jacksonville, FL 32210-3228 | 2006-11-29 |
| 1487737441 | Midtown Dental of Jacksonville | Preferred Provider Organization | 2801 Saint Johns Bluff Rd S, Suite 1, Jacksonville, FL 32246-3761 | 2006-10-23 |
| 1609241918 | Lysandro O. Tapnio Dmd Pa | Preferred Provider Organization | 9272 Arlington Expy, Jacksonville, FL 32225-8212 | 2015-12-11 |
| 1306189683 | T & R Inc | Preferred Provider Organization | 4131 University Blvd S Ste 4a, Jacksonville, FL 32216-4322 | 2013-04-04 |
| 1922361732 | Psi Family Services, Inc. | Preferred Provider Organization | 3890 Dunn Ave, 1104, Jacksonville, FL 32218-6428 | 2012-06-18 |
| 1992019640 | Live Well M.d. | Preferred Provider Organization | 11512 Lake Mead Ave, Building 521, Jacksonville, FL 32256-9680 | 2010-08-04 |
| 1487891859 | Lymphedema Care Center of North Florida, Inc. | Preferred Provider Organization | 8563 Argyle Business Loop, Suite #2, Jacksonville, FL 32244-6668 | 2009-01-07 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32257 |
Please comment or provide details below to improve the information on MEDSPORTS PROMASSAGE.
| 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.