MEDICARE: ELENITA RIVERA CATALAN 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	225700000X	Massage Therapist	MA 35997	FL

General Provider Information

NPI Number	:	1275856569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELENITA RIVERA CATALAN LMT

Provider Business Mailing Address
First Line	:	1625 SW 3RD TER
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33991-1326
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1443 DEL PRADO BLVD S
Second Line	:	ST# A
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-3750
Country	:	US
Telephone Number	:	239-989-7258
Fax Number	:

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

Provider Enumeration Date	:	03/01/2010
Last Update Date	:	03/01/2010

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Directions to “ ELENITA RIVERA CATALAN LMT” Practice Location

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