MEDICARE: MR. RICK BATES LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MA11025	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MA11025	OTHER	FL	FLORIDA DEPARTMENT OF HEALTH MASSAGE LICENSE

General Provider Information

NPI Number	:	1023254877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICK BATES LMT

Provider Business Mailing Address
First Line	:	4443 HAWKSLEY PL
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33545-5218
Country	:	US
Telephone Number	:	813-995-3264
Fax Number	:	813-377-4886

Provider Business Practice Location Address
First Line	:	5801 ARGERIAN DR
Second Line	:	SUITE 101
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33545-4140
Country	:	US
Telephone Number	:	813-995-3264
Fax Number	:	813-377-4886

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2008
Last Update Date	:	12/29/2008

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