Healthcare Provider Details

I. General information

NPI: 1437094059
Provider Name (Legal Business Name): TRANQUIL TOPAZ BODYWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 SW THOMPKINS LOOP
LAKE CITY FL
32025-2154
US

IV. Provider business mailing address

121 SW THOMPKINS LOOP
LAKE CITY FL
32025-2154
US

V. Phone/Fax

Practice location:
  • Phone: 386-623-4579
  • Fax:
Mailing address:
  • Phone: 386-623-4579
  • 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: JULIE FLOYD
Title or Position: OWNER/OPERATOR
Credential: LMT
Phone: 386-623-4579