MEDICARE: BRIUT MASSAGE & THERAPY CENTER

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	261QR0400X	Rehabilitation Clinic/Center	HCC5167	FL

General Provider Information

NPI Number	:	1942353727
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIUT MASSAGE & THERAPY CENTER

Provider Business Mailing Address
First Line	:	3260 W HILLSBOROUGH AVE
Second Line	:	SUITE 104
City	:	TAMPA
State	:	FL
Zip	:	33614-5902
Country	:	US
Telephone Number	:	813-350-0103
Fax Number	:	813-350-0137

Provider Business Practice Location Address
First Line	:	3260 W HILLSBOROUGH AVE
Second Line	:	SUITE 104
City	:	TAMPA
State	:	FL
Zip	:	33614-5902
Country	:	US
Telephone Number	:	813-350-0103
Fax Number	:	813-350-0137

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	MR. ALEXIS TERRERO
Credential	:	LMT
Telephone Number	:	813-350-0103

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	08/22/2020

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