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General NPI Number Information
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NPI Number | 1124995386
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Entity Type | Organization
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Legal Business Name | MEN'S LUXURY SPA LLC
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Dates
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Enumeration Date | 10/22/2025
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 1516 E COLONIAL DR STE 101
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City | ORLANDO
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State | FL
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Zip | 32803-4726
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Country | US
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Telephone | 321-247-5553
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Fax |
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Provider Business Mailing Address
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Address Line | 1516 E COLONIAL DR STE 101
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City | ORLANDO
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State | FL
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Zip | 32803-4726
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Country | US
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Telephone | 321-247-5553
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ERIC RICHARDSON RICHARDSON
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Credential |
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Telephone | 407-885-9633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number |
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License Number State |
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