Healthcare Provider Details

I. General information

NPI: 1982976759
Provider Name (Legal Business Name): GENTLE HANDS MASSAGE THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2012
Last Update Date: 02/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9745 SW 72ND ST SUITE 115
MIAMI FL
33173-4652
US

IV. Provider business mailing address

9745 SW 72ND ST SUITE 115
MIAMI FL
33173-4652
US

V. Phone/Fax

Practice location:
  • Phone: 305-763-2566
  • Fax:
Mailing address:
  • Phone: 305-763-2566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA66107
License Number StateFL

VIII. Authorized Official

Name: MISS ALBERTINA M ROSELL
Title or Position: OWNER
Credential: MA
Phone: 305-763-2566