Healthcare Provider Details

I. General information

NPI: 1225507783
Provider Name (Legal Business Name): ROSEMARY LYNN HURLEY LMT, CST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2018
Last Update Date: 11/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11211 PROSPERITY FARMS RD STE D325
PALM BEACH GARDENS FL
33410-3472
US

IV. Provider business mailing address

11820 SW 20TH ST
DAVIE FL
33325-4600
US

V. Phone/Fax

Practice location:
  • Phone: 561-622-4334
  • Fax:
Mailing address:
  • Phone: 954-290-1838
  • Fax: 954-236-5053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA75481
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: