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General NPI Number Information
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NPI Number | 1881212025
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Entity Type | Individual
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Provider Name | MICHAEL ANTHONY MERREN LAT, ATC, LMT, NREMT
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Gender | Male
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Dates
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Enumeration Date | 07/13/2020
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Last Update Date | 07/13/2020
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Provider Practice Location Address
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Address Line | 7332 NEWHALL PASS LN
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City | WESLEY CHAPEL
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State | FL
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Zip | 33545-8263
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Country | US
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Telephone | 201-674-8062
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Fax |
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Provider Business Mailing Address
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Address Line | 7332 NEWHALL PASS LN
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City | WESLEY CHAPEL
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State | FL
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Zip | 33545-8263
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Country | US
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Telephone |
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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 | MA87773
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AL3817
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License Number State | FL
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