MEDICARE: GUOHUA JIN

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	MA81679	FL

General Provider Information

NPI Number	:	1730643248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUOHUA JIN

Provider Business Mailing Address
First Line	:	5915 MEMORIAL HWY STE 106
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-5008
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5915 MEMORIAL HWY STE 106
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-5008
Country	:	US
Telephone Number	:	813-644-6900
Fax Number	:

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

Provider Enumeration Date	:	01/29/2019
Last Update Date	:	01/29/2019

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Directions to “ GUOHUA JIN ” Practice Location

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