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General NPI Number Information
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NPI Number | 1437538022
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Entity Type | Organization
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Legal Business Name | LIBERTO THERAPY LLC
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Dates
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Enumeration Date | 05/28/2015
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Last Update Date | 05/28/2015
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Provider Practice Location Address
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Address Line | 3520 S OCEAN BLVD APT L-201
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City | PALM BEACH
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State | FL
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Zip | 33480-5788
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Country | US
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Telephone | 561-582-2306
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Fax | 561-585-1984
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Provider Business Mailing Address
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Address Line | 3520 S OCEAN BLVD APT L-201
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City | PALM BEACH
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State | FL
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Zip | 33480-5788
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Country | US
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Telephone | 561-582-2306
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Fax | 561-585-1984
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. THOMAS LIBERTO
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Credential | LMT
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Telephone | 561-582-2306
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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 | MM2078
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License Number State | FL
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