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General NPI Number Information
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NPI Number | 1619215316
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Entity Type | Organization
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Legal Business Name | BODE MEDICAL CENTER, INC.
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Dates
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Enumeration Date | 01/30/2013
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Last Update Date | 05/06/2013
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Provider Practice Location Address
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Address Line | 12144 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34613-5575
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Country | US
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Telephone | 813-900-5690
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Fax | 352-600-9234
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Provider Business Mailing Address
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Address Line | 231 ROYAL PALM WAY
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City | SPRING HILL
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State | FL
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Zip | 34608-9425
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Country | US
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Telephone | 813-900-5690
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Fax | 352-600-9234
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Authorized Official
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Title or Position | LICENSED MASSAGE THERAPIST
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Name | YENIFER SAEZ
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Credential | LMT
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Telephone | 813-900-5690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | HCC10528
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License Number State | FL
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