Healthcare Provider Details

I. General information

NPI: 1437298536
Provider Name (Legal Business Name): RITA YVONNE LAWSON L.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 W PATTERSON ST
TAMPA FL
33604-4720
US

IV. Provider business mailing address

1107 W PATTERSON ST
TAMPA FL
33604-4720
US

V. Phone/Fax

Practice location:
  • Phone: 813-610-1032
  • Fax:
Mailing address:
  • Phone: 813-610-1032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License NumberMA32143
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: