=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205787140
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MINTZ MASSAGE & WELLNESS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/06/2026
-----------------------------------------------------
Last Update Date | 02/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6000 PENINSULAR AVE
-----------------------------------------------------
City | KEY WEST
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33040-6082
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-883-7795
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6000 PENINSULAR AVE
-----------------------------------------------------
City | KEY WEST
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33040-6082
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-883-7795
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JOSIE RENEE MINTZ LESPERANCE
-----------------------------------------------------
Credential | MA, LMT, C-MLD
-----------------------------------------------------
Telephone | 786-883-7795
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------