MEDICARE: VIE SAINTE

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	MA37623	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MA37623	OTHER	FL	FLORIDA STATE MASSAGE THERAPY LICENSE

General Provider Information

NPI Number	:	1548436066
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIE SAINTE

Provider Business Mailing Address
First Line	:	3130 S CONGRESS AVE
Second Line	:	STE B
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-2552
Country	:	US
Telephone Number	:	561-721-1251
Fax Number	:	561-721-1057

Provider Business Practice Location Address
First Line	:	3130 S CONGRESS AVE
Second Line	:	STE B
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-2552
Country	:	US
Telephone Number	:	561-721-1251
Fax Number	:	561-721-1057

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. SNJEZANA SAN MARTIN
Credential	:	LMT
Telephone Number	:	561-721-1251

Provider Enumeration Date	:	05/05/2008
Last Update Date	:	05/05/2008

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Directions to “VIE SAINTE ” Practice Location

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