Healthcare Provider Details

I. General information

NPI: 1376452847
Provider Name (Legal Business Name): GISSEL BURGOS ROBLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10329 CROSS CREEK BOULEVARD, TAMPA, FL, 33647 SUITE K
TAMPA FL
33647
US

IV. Provider business mailing address

35147 JOMAR AVE
ZEPHYRHILLS FL
33541-5096
US

V. Phone/Fax

Practice location:
  • Phone: 813-482-2117
  • Fax:
Mailing address:
  • Phone: 813-593-3482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA68780
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA73201
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: