MEDICARE: NICOLETTE GLORIA CATALANO L.M.T

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	MA92598	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MA92598	OTHER	FL	MASSAGE THERAPIST

General Provider Information

NPI Number	:	1952998866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLETTE GLORIA CATALANO L.M.T

Provider Business Mailing Address
First Line	:	3618 CALLOWAY DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32810-2218
Country	:	US
Telephone Number	:	772-559-6788
Fax Number	:

Provider Business Practice Location Address
First Line	:	3618 CALLOWAY DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32810-2218
Country	:	US
Telephone Number	:	772-559-6788
Fax Number	:

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

Provider Enumeration Date	:	12/26/2020
Last Update Date	:	12/26/2020

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