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General NPI Number Information
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NPI Number | 1306587001
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Entity Type | Individual
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Provider Name | DESTINEY LARKIN
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Gender | Female
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 04/05/2022
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Provider Practice Location Address
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Address Line | 2265 LEE RD STE 204
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City | WINTER PARK
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State | FL
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Zip | 32789-1860
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Country | US
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Telephone | 321-328-7041
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Fax |
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Provider Business Mailing Address
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Address Line | 537 ONE CENTER BLVD APT E316
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-2242
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Country | US
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Telephone | 407-288-4423
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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 | MA95273
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License Number State | FL
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