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General NPI Number Information
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NPI Number | 1003828112
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Entity Type | Organization
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Legal Business Name | SERENDIPITY THERAPEUTIC MASSAGE AND BODYWORK, INC.
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 727 COLORADO AVE COLORADO PLAZA
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City | STUART
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State | FL
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Zip | 34994-3017
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Country | US
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Telephone | 772-781-7494
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Fax | 772-781-7491
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Provider Business Mailing Address
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Address Line | 727 COLORADO AVE COLORADO PLAZA
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City | STUART
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State | FL
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Zip | 34994-3017
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Country | US
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Telephone | 772-781-7494
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Fax | 772-781-7491
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | MS. CYNTHIAANN LEE HAYES
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Credential | LMT
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Telephone | 772-781-7494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MM17279
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License Number State | FL
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