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General NPI Number Information
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NPI Number | 1184963647
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Entity Type | Individual
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Provider Name | RENEE ESCOBAR L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 02/04/2013
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 1939 S TAMIAMI TRL
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City | VENICE
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State | FL
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Zip | 34293-5004
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Country | US
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Telephone | 253-686-9708
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1175
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City | NOKOMIS
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State | FL
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Zip | 34274-1175
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Country | US
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Telephone | 253-686-9608
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | MA00012315
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA87242
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License Number State | FL
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