Healthcare Provider Details

I. General information

NPI: 1821238387
Provider Name (Legal Business Name): MASSAGE & HEALING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2009
Last Update Date: 02/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1914 N HIMES AVE
TAMPA FL
33607-4219
US

IV. Provider business mailing address

PO BOX 263504
TAMPA FL
33685-3504
US

V. Phone/Fax

Practice location:
  • Phone: 813-374-9142
  • Fax: 813-374-9144
Mailing address:
  • Phone: 813-374-9142
  • Fax: 813-374-9144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License NumberHCC7224
License Number StateFL

VIII. Authorized Official

Name: MR. JORGE MONTOYA ROMERO
Title or Position: OWNER
Credential: LMT
Phone: 813-374-9142