MEDICARE: MR. ROBERT COURTENAY LMT, RMT, NCTMB

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	MA60193	FL

General Provider Information

NPI Number	:	1316246481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT COURTENAY LMT, RMT, NCTMB

Provider Business Mailing Address
First Line	:	5036 DR PHILLIPS BLVD
Second Line	:	SUITE 375
City	:	ORLANDO
State	:	FL
Zip	:	32819-3310
Country	:	US
Telephone Number	:	407-601-4036
Fax Number	:	407-601-4036

Provider Business Practice Location Address
First Line	:	5036 DR PHILLIPS BLVD
Second Line	:	SUITE 375
City	:	ORLANDO
State	:	FL
Zip	:	32819-3310
Country	:	US
Telephone Number	:	407-601-4036
Fax Number	:	407-601-4036

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

Provider Enumeration Date	:	03/15/2011
Last Update Date	:	04/27/2012

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