Healthcare Provider Details

I. General information

NPI: 1063377240
Provider Name (Legal Business Name): SAFIYA SMTH LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2638 NARNIA WAY UNIT 101
LAND O LAKES FL
34638-7321
US

IV. Provider business mailing address

2811 S 63RD ST
TAMPA FL
33619-6221
US

V. Phone/Fax

Practice location:
  • Phone: 727-541-2520
  • Fax:
Mailing address:
  • Phone: 954-203-8496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA107129
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: