MEDICARE: ANA FORERO HENAO

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	83747	FL

General Provider Information

NPI Number	:	1619757754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA FORERO HENAO

Provider Business Mailing Address
First Line	:	7329 W OAKLAND PARK BLVD
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33319-7109
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7329 W OAKLAND PARK BLVD
Second Line	:
City	:	TAMARAC
State	:	FL
Zip	:	33319-7109
Country	:	US
Telephone Number	:	954-249-5048
Fax Number	:

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

Provider Enumeration Date	:	10/05/2023
Last Update Date	:	10/05/2023

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Directions to “ ANA FORERO HENAO ” Practice Location

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