MEDICARE: MARIA E TENGLIA MT

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	MA27346	FL

General Provider Information

NPI Number	:	1043267487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA E TENGLIA MT

Provider Business Mailing Address
First Line	:	3028 E COMMERCIAL BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-4312
Country	:	US
Telephone Number	:	954-229-9222
Fax Number	:	954-229-9224

Provider Business Practice Location Address
First Line	:	3028 E COMMERCIAL BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-4312
Country	:	US
Telephone Number	:	954-229-9222
Fax Number	:	954-229-9224

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

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	07/08/2007

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Directions to “ MARIA E TENGLIA MT” Practice Location

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