MEDICARE: KARIN WHITBECK 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	MA 16850	FL

General Provider Information

NPI Number	:	1356552715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARIN WHITBECK L.M.T

Provider Business Mailing Address
First Line	:	100 MADRID BLVD UNIT 411
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33950-8929
Country	:	US
Telephone Number	:	941-833-3344
Fax Number	:	941-833-0328

Provider Business Practice Location Address
First Line	:	100 MADRID BLVD UNIT 411
Second Line	:
City	:	PUNTA GORDA
State	:	FL
Zip	:	33950-8929
Country	:	US
Telephone Number	:	941-833-3344
Fax Number	:	941-833-0328

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

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	07/08/2007

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