MEDICARE: NANCY ORELUS MASSAGETHERAPIST

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	22412247	FL

General Provider Information

NPI Number	:	1649598483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY ORELUS MASSAGETHERAPIST

Provider Business Mailing Address
First Line	:	2500 PARKVIEW DR APT 618C
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009-2806
Country	:	US
Telephone Number	:	954-993-3881
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 PARK VIEW DR. APT#618C
Second Line	:
City	:	HALLANDALE BEACH
State	:	FL
Zip	:	33009
Country	:	US
Telephone Number	:	954-993-3881
Fax Number	:

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

Provider Enumeration Date	:	05/04/2010
Last Update Date	:	05/04/2010

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