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General NPI Number Information
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NPI Number | 1891014734
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Entity Type | Individual
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Provider Name | ARMANDO JOHN DIBENEDETTO LMT
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Gender | Male
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Dates
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Enumeration Date | 05/18/2010
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Last Update Date | 05/18/2010
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Provider Practice Location Address
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Address Line | 1809 TOWN CENTER BLVD STE 3
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-4322
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Country | US
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Telephone | 904-278-3878
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Fax | 904-579-4270
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Provider Business Mailing Address
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Address Line | 1809 TOWN CENTER BLVD STE 3
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City | FLEMING ISLAND
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State | FL
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Zip | 32003-4322
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Country | US
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Telephone | 904-278-3878
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Fax | 904-579-4270
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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 | MA54075
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License Number State | FL
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