Healthcare Provider Details

I. General information

NPI: 1538282751
Provider Name (Legal Business Name): NEIL TREITMAN M.A
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1931 S TUTTLE AVE
SARASOTA FL
34239-3115
US

IV. Provider business mailing address

PO BOX 25187
SARASOTA FL
34277-2187
US

V. Phone/Fax

Practice location:
  • Phone: 941-957-4500
  • Fax: 941-957-4501
Mailing address:
  • Phone: 941-957-4500
  • Fax: 947-957-4501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA 40757
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: