MEDICARE: MUNI NG 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	MA97327

General Provider Information

NPI Number	:	1043883580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUNI NG LMT

Provider Business Mailing Address
First Line	:	61 HOLIDAY DR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1283 N OCEAN DR
Second Line	:
City	:	RIVIERA BEACH
State	:	FL
Zip	:	33404-4739
Country	:	US
Telephone Number	:	561-713-9882
Fax Number	:

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

Provider Enumeration Date	:	07/22/2021
Last Update Date	:	07/22/2021

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Directions to “ MUNI NG LMT” Practice Location

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