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General NPI Number Information
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NPI Number | 1215498977
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Entity Type | Individual
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Provider Name | TONYA MARIE CARSON LMT
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Gender | Female
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 03/26/2019
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Provider Practice Location Address
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Address Line | 5385 CONROY RD STE 201
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City | ORLANDO
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State | FL
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Zip | 32811-3719
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Country | US
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Telephone | 407-516-2610
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Fax |
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Provider Business Mailing Address
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Address Line | 7206 MANDARIN DR
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City | ORLANDO
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State | FL
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Zip | 32819-8463
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Country | US
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Telephone | 407-235-8498
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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 | MA63200
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License Number State | FL
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