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General NPI Number Information
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NPI Number | 1760376115
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Entity Type | Individual
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Provider Name | ELIZABETH MARIA BRUER
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Gender | Female
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 420 NOKOMIS AVE S
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City | VENICE
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State | FL
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Zip | 34285-2617
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Country | US
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Telephone | 941-426-9551
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 KINGS HWY LOT 732
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City | PORT CHARLOTTE
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State | FL
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Zip | 33980-4272
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Country | US
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Telephone | 941-457-6999
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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 | MA9980
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License Number State | FL
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