MEDICARE: TINA MONROE 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
1	225700000X	Massage Therapist	MA41050	FL

General Provider Information

NPI Number	:	1013476795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA MONROE LMT

Provider Business Mailing Address
First Line	:	9165 SE 47TH COURT RD
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34480-5288
Country	:	US
Telephone Number	:	352-427-6787
Fax Number	:

Provider Business Practice Location Address
First Line	:	3305 SW 34TH CIR STE 203
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34474-6606
Country	:	US
Telephone Number	:	352-351-5019
Fax Number	:	352-224-1975

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2019
Last Update Date	:	03/13/2019

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Directions to “ TINA MONROE LMT” Practice Location

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