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General NPI Number Information
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NPI Number | 1114224045
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Entity Type | Organization
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Legal Business Name | ANGIENIUS MASSAGE
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Dates
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Enumeration Date | 02/10/2011
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Last Update Date | 02/10/2011
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Provider Practice Location Address
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Address Line | 2300 S PINE AVE
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City | OCALA
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State | FL
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Zip | 34471-5102
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Country | US
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Telephone | 352-875-3675
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Fax | 352-240-3867
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Provider Business Mailing Address
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Address Line | 13426 SW 63RD TER
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City | OCALA
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State | FL
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Zip | 34473-6886
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Country | US
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Telephone | 352-875-3675
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Fax | 352-240-3867
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Authorized Official
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Title or Position | OWNER
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Name | ANGELICA MARIA CARLOZZI
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Credential | LMT
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Telephone | 352-875-3675
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | MA58340
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License Number State | FL
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