MEDICARE: MS. CHELSEA SPANEVELLO PTA, 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	225200000X	Physical Therapy Assistant	PTA29042	FL
2	225700000X	Massage Therapist	MA# 45010	FL

General Provider Information

NPI Number	:	1245438571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHELSEA SPANEVELLO PTA, LMT

Provider Business Mailing Address
First Line	:	8477 S SUNCOAST BLVD
Second Line	:
City	:	HOMOSASSA
State	:	FL
Zip	:	34446-5028
Country	:	US
Telephone Number	:	800-381-0822
Fax Number	:	352-565-5201

Provider Business Practice Location Address
First Line	:	8477 S SUNCOAST BLVD
Second Line	:
City	:	HOMOSASSA
State	:	FL
Zip	:	34446-5028
Country	:	US
Telephone Number	:	800-381-0822
Fax Number	:	352-565-5201

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

Provider Enumeration Date	:	07/09/2007
Last Update Date	:	01/29/2025

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