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General NPI Number Information
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NPI Number | 1093067720
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Entity Type | Organization
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Legal Business Name | NEOBODY INC
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Dates
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Enumeration Date | 10/04/2012
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Last Update Date | 07/06/2013
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Provider Practice Location Address
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Address Line | 1435 W BUSCH BLVD STE B
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City | TAMPA
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State | FL
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Zip | 33612-7621
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Country | US
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Telephone | 813-473-2744
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Fax | 813-434-1624
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Provider Business Mailing Address
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Address Line | 1435 W BUSCH BLVD STE B
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City | TAMPA
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State | FL
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Zip | 33612-7621
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Country | US
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Telephone | 813-473-2744
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Fax | 813-434-1624
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Authorized Official
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Title or Position | MASSAGE THERAPIST/ OWNER
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Name | AJAYI MILLER
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Credential | L.M.T, B.P
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Telephone | 813-473-2744
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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 | MA 68053
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License Number State | FL
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