MEDICARE: KEITH BERNABEI

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	MA42038	FL

General Provider Information

NPI Number	:	1831648724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEITH BERNABEI

Provider Business Mailing Address
First Line	:	9579 121ST ST
Second Line	:
City	:	SEMINOLE
State	:	FL
Zip	:	33772-2604
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2480 E BAY DR # 13
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33771-2467
Country	:	US
Telephone Number	:	727-530-7778
Fax Number	:

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

Provider Enumeration Date	:	10/03/2016
Last Update Date	:	10/03/2016

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Directions to “ KEITH BERNABEI ” Practice Location

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