Healthcare Provider Details

I. General information

NPI: 1245320159
Provider Name (Legal Business Name): MRC TECHS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 SEVEN SPRINGS BLVD
NEW PORT RICHEY FL
34655-5643
US

IV. Provider business mailing address

1310 SEVEN SPRINGS BLVD
NEW PORT RICHEY FL
34655-5643
US

V. Phone/Fax

Practice location:
  • Phone: 727-372-9500
  • Fax: 727-372-1268
Mailing address:
  • Phone: 727-372-9500
  • Fax: 727-372-1268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA20611
License Number StateFL

VIII. Authorized Official

Name: MR. MICHAEL A CANIZIO
Title or Position: OFFICER
Credential: MA
Phone: 727-372-9500