MEDICARE: MR. SERGIO ARTEAGA 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 23524	FL

General Provider Information

NPI Number	:	1598017295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SERGIO ARTEAGA L.M.T

Provider Business Mailing Address
First Line	:	100 ABACO DR
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-2002
Country	:	US
Telephone Number	:	305-962-7879
Fax Number	:

Provider Business Practice Location Address
First Line	:	6300 S DIXIE HWY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33405-4348
Country	:	US
Telephone Number	:	561-296-1116
Fax Number	:

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

Provider Enumeration Date	:	10/05/2012
Last Update Date	:	10/05/2012

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