Healthcare Provider Details

I. General information

NPI: 1336043561
Provider Name (Legal Business Name): AMARI ALEXIS ARTIS LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 HARBOR ISLAND DR
FLEMING ISLAND FL
32003-7258
US

IV. Provider business mailing address

1905 HARBOR ISLAND DR
FLEMING ISLAND FL
32003-7258
US

V. Phone/Fax

Practice location:
  • Phone: 757-401-3029
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number110043
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: