Healthcare Provider Details

I. General information

NPI: 1003828112
Provider Name (Legal Business Name): SERENDIPITY THERAPEUTIC MASSAGE AND BODYWORK, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

727 COLORADO AVE COLORADO PLAZA
STUART FL
34994-3017
US

IV. Provider business mailing address

727 COLORADO AVE COLORADO PLAZA
STUART FL
34994-3017
US

V. Phone/Fax

Practice location:
  • Phone: 772-781-7494
  • Fax: 772-781-7491
Mailing address:
  • Phone: 772-781-7494
  • Fax: 772-781-7491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMM17279
License Number StateFL

VIII. Authorized Official

Name: MS. CYNTHIAANN LEE HAYES
Title or Position: OWNER PRESIDENT
Credential: LMT
Phone: 772-781-7494