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General NPI Number Information
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NPI Number | 1275770026
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Entity Type | Organization
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Legal Business Name | REMEMBER SPA & WELLNESS CENTER
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Dates
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Enumeration Date | 01/15/2009
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Last Update Date | 01/15/2009
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Provider Practice Location Address
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Address Line | 2627 N ATLANTIC AVE
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City | DAYTONA BEACH
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State | FL
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Zip | 32118-3205
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Country | US
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Telephone | 386-677-1444
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Fax |
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Provider Business Mailing Address
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Address Line | 2627 N ATLANTIC AVE
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City | DAYTONA BEACH
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State | FL
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Zip | 32118-3205
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Country | US
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Telephone | 386-677-1444
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROSITSA R. AVDZHIEVA
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Credential | BS IN PSYCHOLOGY
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Telephone | 386-677-1444
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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 | MA 44890
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License Number State | FL
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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 | MM 21927
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA45229
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License Number State | FL
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