MR. BO GONG
NPI 1407115835
Massage Therapist in Melbourne, FL

Q: What is Bo Gong's NPI number?

The NPI number for Bo Gong is 1407115835. It was assigned to this individual provider in the NPPES registry on May 4, 2012. The provider is also known as Dr. Jack Zhao Dr. Jack.

Q: What is Bo Gong's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

Q: When was this NPI record last updated?

The NPPES record for Bo Gong was last updated on February 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 04, 2012

6559 N WICKHAM RD # C-103, MELBOURNE, FL 32940(407) 861-6966 Get Directions Write a Review

NPPES record last updated: February 4, 2025. Verified against the NPPES registry weekly; last sync: September 06, 2026.

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About Mr. Bo Gong NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. BO GONG (NPI 1407115835) is an individual massage therapist in Melbourne, Florida, licensed in Florida (MA68483) and active in the NPI registry since May 2012. He maintains a secondary practice location in Kissimmee.

NPPES Registry Identity

NPI1407115835

Entity TypeIndividualMale

Primary Taxonomy225700000X

Provider Legal NameMR. BO GONG

Location Address6559 N WICKHAM RD # C-103Melbourne, FL 32940-2052

Mailing Address2579 Oak StKissimmee, FL 34744-4946 · (407) 288-4865

Phone(407) 861-6966

Sole ProprietorYes

Enumeration DateMay 4, 2012

Last NPPES UpdateFebruary 4, 2025

NPPES CertifiedFebruary 4, 2025

✔ NPI 1407115835 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code225700000X

License✔ Licensed in FL · MA68483

Definition

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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License MA68483 (FL)

6559 N WICKHAM RD # C-103, Melbourne, FL 32940

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Other Names 1

Professional Name (2)Dr. Jack Zhao Dr. Jack

Secondary Practice Location 1

Location 12579 Oak StKissimmee, FL 34744-4946 · Phone (407) 288-4865

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bo Gong's NPI number?

The NPI number for Bo Gong is 1407115835. It was assigned to this individual provider in the NPPES registry on May 4, 2012. The provider is also known as Dr. Jack Zhao Dr. Jack.

Where is Bo Gong located?

Bo Gong practices at 6559 N Wickham Rd # C-103, Melbourne, FL 32940. The listed phone number is (407) 861-6966.

What is Bo Gong's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Bo Gong was last updated on February 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.