=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790967867
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALLEYZEE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/30/2007
-----------------------------------------------------
Last Update Date | 04/01/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1679 EAGLE HARBOR PKWY EAST SUITE C
-----------------------------------------------------
City | ORANGE PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32003-4816
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-264-7200
-----------------------------------------------------
Fax | 904-264-7755
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1679 EAGLE HARBOR PKWY SUITE C
-----------------------------------------------------
City | ORANGE PARK
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32003-4816
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-264-7200
-----------------------------------------------------
Fax | 904-264-7755
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | JEANINE B MAGSITZA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 904-264-7200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | MM 21180
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 2080138847342
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 335E00000X
-----------------------------------------------------
Taxonomy Name | Prosthetic/Orthotic Supplier
-----------------------------------------------------
License Number | 2080138847342
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------