MEDICARE: CYNTHIA MARIE ENGLISH MT

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	MA51329	FL

General Provider Information

NPI Number	:	1649543547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA MARIE ENGLISH MT

Provider Business Mailing Address
First Line	:	600 SE HWY 19
Second Line	:	SUITE C
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34429
Country	:	US
Telephone Number	:	352-634-2783
Fax Number	:

Provider Business Practice Location Address
First Line	:	8934 S WATERVIEW DR
Second Line	:
City	:	FLORAL CITY
State	:	FL
Zip	:	34436-3630
Country	:	US
Telephone Number	:	352-634-2783
Fax Number	:

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

Provider Enumeration Date	:	02/23/2012
Last Update Date	:	02/23/2012

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