Healthcare Provider Details

I. General information

NPI: 1699630707
Provider Name (Legal Business Name): COURTNEY ANDAYA MT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 INDUSTRIAL BLVD
PENSACOLA FL
32505-2201
US

IV. Provider business mailing address

119 INDUSTRIAL BLVD
PENSACOLA FL
32505-2201
US

V. Phone/Fax

Practice location:
  • Phone: 850-904-4344
  • Fax:
Mailing address:
  • Phone: 850-904-4344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number108805
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: