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General NPI Number Information
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NPI Number | 1376756619
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Entity Type | Organization
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Legal Business Name | ADVANCED THERAPY SOLUTIONS INC
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 01/21/2009
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Provider Practice Location Address
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Address Line | 385 DOUGLAS AVE SUITE 1100
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-3339
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Country | US
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Telephone | 407-788-7515
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Fax | 407-788-3450
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Provider Business Mailing Address
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Address Line | 385 DOUGLAS AVE SUITE 1100
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-3339
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Country | US
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Telephone | 407-788-7515
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Fax | 407-788-3450
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Authorized Official
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Title or Position | OWNER
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Name | MR. EBERTO LOPEZ
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Credential | MASSAGE THERAPIST
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Telephone | 407-788-7515
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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 | MM15195
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License Number State | FL
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