Healthcare Provider Details

I. General information

NPI: 1023701109
Provider Name (Legal Business Name): CRISTINA CABEZAS EURY BA, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2023
Last Update Date: 06/02/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 NEWBERRY RD STE C4
GAINESVILLE FL
32607-2380
US

IV. Provider business mailing address

3300 NW 26TH AVE
GAINESVILLE FL
32605-2701
US

V. Phone/Fax

Practice location:
  • Phone: 352-888-4596
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberMA70584
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License NumberMA70584
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA70584
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: