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General NPI Number Information
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NPI Number | 1427238427
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Entity Type | Individual
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Provider Name | MRS. PATRICIA J ANASTASIO II
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Gender | Female
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Dates
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Enumeration Date | 11/07/2007
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Last Update Date | 11/07/2007
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Provider Practice Location Address
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Address Line | 1203 MAYFLOWER DR
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City | LAKELAND
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State | FL
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Zip | 33810-3621
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Country | US
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Telephone | 863-670-0335
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Fax | 863-858-1516
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Provider Business Mailing Address
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Address Line | 690 HUNTERS RUN BLVD
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City | LAKELAND
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State | FL
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Zip | 33809-6654
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Country | US
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Telephone | 863-670-0335
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Fax | 863-858-1516
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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 | MA40371
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License Number State | FL
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