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NPI Code Detail

MEDICARE: MAYUMI MOREIRA LMT

MEDICARE: MAYUMI MOREIRA LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMA46565FL

General Provider Information

NPI Number : 1003018581
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAYUMI MOREIRA LMT
Provider Business Mailing Address
First Line : 13909 N DALE MABRY HWY STE 101
Second Line :
City : TAMPA
State : FL
Zip : 33618-2435
Country : US
Telephone Number : 813-728-7786
Fax Number : 813-443-5727
Provider Business Practice Location Address
First Line : 13909 N DALE MABRY HWY STE 101
Second Line :
City : TAMPA
State : FL
Zip : 33618-2435
Country : US
Telephone Number : 813-728-7786
Fax Number : 813-443-5727
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2007
Last Update Date : 10/29/2012

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