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General NPI Number Information
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NPI Number | 1083037634
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Entity Type | Organization
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Legal Business Name | LA MASSAGE BY DESIGN
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Dates
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Enumeration Date | 01/31/2014
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Last Update Date | 01/31/2014
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Provider Practice Location Address
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Address Line | 11450 W SAMPLE RD
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-7053
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Country | US
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Telephone | 954-736-9035
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Fax |
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Provider Business Mailing Address
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Address Line | 11450 W SAMPLE RD
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City | CORAL SPRINGS
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State | FL
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Zip | 33065-7053
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Country | US
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Telephone | 954-736-9035
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS LUZ BEATRIZ ACOSTA
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Credential | MA
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Telephone | 954-736-9035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175L00000X
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Taxonomy Name | Homeopath
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License Number | MA57591
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License Number State | FL
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