MEDICARE: NATALIE VAUSE L.M.T

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	225700000X	Massage Therapist	MA47794	FL
2	171100000X	Acupuncturist	AP3086	FL

General Provider Information

NPI Number	:	1093083123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE VAUSE L.M.T

Provider Business Mailing Address
First Line	:	1515 PARK CENTER DR
Second Line	:	SUITE 2M
City	:	ORLANDO
State	:	FL
Zip	:	32835-5794
Country	:	US
Telephone Number	:	407-900-3062
Fax Number	:

Provider Business Practice Location Address
First Line	:	1515 PARK CENTER DR
Second Line	:	SUITE 2M
City	:	ORLANDO
State	:	FL
Zip	:	32835-5794
Country	:	US
Telephone Number	:	407-900-3062
Fax Number	:

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

Provider Enumeration Date	:	12/04/2011
Last Update Date	:	02/13/2013

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