Healthcare Provider Details

I. General information

NPI: 1780548594
Provider Name (Legal Business Name): SENGA F BLAIR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5599 STEWART ST
MILTON FL
32570-4344
US

IV. Provider business mailing address

3702 ROCKWOOD DR
MILTON FL
32571-1867
US

V. Phone/Fax

Practice location:
  • Phone: 850-530-8082
  • Fax: 448-216-2818
Mailing address:
  • Phone: 850-530-8082
  • Fax: 448-216-2818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA107774
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: