Healthcare Provider Details

I. General information

NPI: 1003770991
Provider Name (Legal Business Name): REJUVENATIONS ON THE GO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2787 E OAKLAND PARK BLVD STE 401
FORT LAUDERDALE FL
33306-1632
US

IV. Provider business mailing address

2787 E OAKLAND PARK BLVD STE 401 401
FORT LAUDERDALE FL
33306-1632
US

V. Phone/Fax

Practice location:
  • Phone: 954-305-4454
  • Fax:
Mailing address:
  • Phone: 954-305-4454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: TREISA J HEIGHTS
Title or Position: MANAGER
Credential: LMT
Phone: 954-657-1100