Healthcare Provider Details

I. General information

NPI: 1174301931
Provider Name (Legal Business Name): BRIANNA TREANTOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2023
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 E BAY DR
LARGO FL
33771-2467
US

IV. Provider business mailing address

2480 E BAY DR
LARGO FL
33771-2467
US

V. Phone/Fax

Practice location:
  • Phone: 727-530-7778
  • Fax: 727-530-7797
Mailing address:
  • Phone: 727-530-7778
  • Fax: 727-530-7797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: