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General NPI Number Information
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NPI Number | 1972726750
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Entity Type | Individual
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Provider Name | PETER GOROBETZ L.M.T.
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Gender | Male
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 01/25/2012
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Provider Practice Location Address
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Address Line | 75 E PROSPECT RD SUITE 4B
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City | OAKLAND PARK
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State | FL
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Zip | 33334-1400
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Country | US
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Telephone | 954-551-1446
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Fax |
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Provider Business Mailing Address
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Address Line | 3095 N COURSE DR APT. # 203
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City | POMPANO BEACH
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State | FL
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Zip | 33069-3368
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Country | US
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Telephone | 954-551-1446
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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 | MA43276
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License Number State | FL
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