LORI JEAN CLISSOLD (NPI# 1184042483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184042483 |
| Entity Type | Individual |
| Full Name | LORI JEAN CLISSOLD |
| Practice Address |
10033 Dr Martin Luther King Jr St N Ste 300 St Petersburg FL 33716-3830 |
| Mailing Address |
301 W Platt St Ste 24 Tampa FL 33606-2292 |
| Practice Telephone | 7274988898 |
| Practice Fax Number | 7278006959 |
| Mailing Telephone | 7274988898 |
| Mailing Fax Number | 7278006959 |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2014-04-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MA 64886 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
10033 DR MARTIN LUTHER KING JR ST N STE 300 |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33716-3830 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699205815 | Orthopaedic Medical Group of Tampa Bay Pa | Clinic/Center | 10033 Mlk Jr St N Fl 3, St Petersburg, FL 33716 | 2017-06-20 |
| 1316471113 | Sara Alexandra Maltese | Dentist | 871 Ibis Walk Pl N Unit 7201, St Petersburg, FL 33716 | 2017-04-18 |
| 1508229972 | Florida Cardiac Therapeutics, Inc | Internal Medicine | 10033 Doctor M.l.k. Jr St N, Suite 302, St Petersburg, FL 33716 | 2016-04-01 |
| 1720440902 | Valorie Baker | Day Training, Developmentally Disabled Services | 115 112th Ave Ne Apt 627, St Petersburg, FL 33716 | 2016-03-25 |
| 1346611142 | Theresa Bowen | Occupational Therapist | 810 S. Village Drive N, #103, St. Petersburg, FL 33716 | 2015-10-19 |
| 1356775423 | Paula J Smith | Massage Therapist | 400 Carillon Pkwy #130, Mountain Tree Massage, LLC, St. Petersburg, FL 33716 | 2013-08-26 |
| 1699118596 | Kellie L Kintz | Social Worker | 540 Carillon Parkway, Apartment 3026, The Promenade At Carillon, St. Petersburg, FL 33716 | 2013-04-10 |
| 1427398288 | St. Petersburg General Hospital | General Acute Care Hospital | 11850 Doctor Martin Luther King Jr. St. North, Apt 22-312, St Petersburg, FL 33716 | 2013-02-15 |
| 1952657314 | Trudy Anna Glover | Occupational Therapy Assistant | 11850 9th Street North, Apt 20208, St Petersburg, FL 33716 | 2012-08-02 |
| 1275834129 | Prison Rehabilitative Industries & Diversified Enterprises | Dental Laboratory | 12425 28th St. N., Suite 300, St. Petersburg, FL 33716 | 2010-11-09 |
| Find all providers in zip 33716 | ||||
| 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 |
|---|---|---|---|---|
| 1477150134 | Traci Jones | Massage Therapist | 12000 4th St N Apt 44, St Petersburg, FL 33716-1710 | 2020-10-06 |
| 1073129961 | James F Thomason | Massage Therapist | 1211 1st Ave N # 211, St Petersburg, FL 33705-1567 | 2020-09-16 |
| 1225683212 | Tracy Baker | Massage Therapist | 2040 30th St S, St Petersburg, FL 33712-2947 | 2019-08-06 |
| 1487116414 | Joseph Scott Hendershot | Massage Therapist | 430 3rd Ave S Apt 232, St Petersburg, FL 33701-4183 | 2019-03-31 |
| 1003315516 | Carl James Rutledge | Massage Therapist | 7229 Central Ave, St Petersburg, FL 33710-7413 | 2018-02-10 |
| 1649676644 | Jaime Whittington | Massage Therapist | 249 57th St N, St Petersburg, FL 33710-7931 | 2014-11-18 |
| 1801217609 | Chad Cook | Massage Therapist | 400 Carillon Pkwy Ste 130, St Petersburg, FL 33716-1290 | 2013-12-20 |
| 1730437237 | Lanett Montoya | Massage Therapist | 500 Mlk St N, Suite 100, St Petersburg, FL 33705-1472 | 2012-08-15 |
| 1679854392 | Katherine Ann Youhn | Massage Therapist | 3202 Dr Ml King Jr St N, St Petersburg, FL 33704-1202 | 2011-09-08 |
| 1497043426 | Danielle Alexis Buyea | Massage Therapist | 680 79th Ter N, 311, St Petersburg, FL 33702-4392 | 2011-07-11 |
| Find all providers in ST PETERSBURG | ||||
| City | ST PETERSBURG |
| Zip Code | 33716 |
Please comment or provide details below to improve the information on LORI JEAN CLISSOLD.
| 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.