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General NPI Number Information
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NPI Number | 1457544777
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Entity Type | Individual
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Provider Name | PAMELA RAE KAURANEN-DIROCCO M.T.
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Gender | Female
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 08/21/2007
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Provider Practice Location Address
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Address Line | 1125 12TH ST STE E
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City | VERO BEACH
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State | FL
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Zip | 32960-3791
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Country | US
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Telephone | 772-778-8890
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Fax |
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Provider Business Mailing Address
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Address Line | 626 19TH PL SW
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City | VERO BEACH
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State | FL
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Zip | 32962-7014
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Country | US
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Telephone | 772-567-5458
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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 | MA50215
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License Number State | FL
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