=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730030404
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GISSEL CAL MT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/06/2026
-----------------------------------------------------
Last Update Date | 02/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14222 SW 48TH LN
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33175-5022
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-388-1118
-----------------------------------------------------
Fax | 305-223-3242
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14222 SW 48TH LN
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33175-5022
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-388-1118
-----------------------------------------------------
Fax | 305-223-3242
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | M29610
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------