MEDICARE: ELIZABETH CAPPELLO LMT, RN

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	MA66085	FL
2	163W00000X	Registered Nurse	RN9424184	FL

General Provider Information

NPI Number	:	1033649918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH CAPPELLO LMT, RN

Provider Business Mailing Address
First Line	:	5441 SW ORCHID BAY DR
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-8522
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5441 SW ORCHID BAY DR
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-8522
Country	:	US
Telephone Number	:	203-824-4611
Fax Number	:

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

Provider Enumeration Date	:	06/14/2017
Last Update Date	:	06/14/2017

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