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NPI Code Detail

MEDICARE: TANYA WOLF

MEDICARE:   TANYA  WOLF
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 TherapistMA40126FL

General Provider Information

NPI Number : 1083087027
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANYA WOLF
Provider Business Mailing Address
First Line : 4121 NEPTUNE RD
Second Line :
City : SAINT CLOUD
State : FL
Zip : 34769-6741
Country : US
Telephone Number : 407-738-7412
Fax Number :
Provider Business Practice Location Address
First Line : 4121 NEPTUNE RD
Second Line :
City : SAINT CLOUD
State : FL
Zip : 34769-6741
Country : US
Telephone Number : 407-738-7412
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2015
Last Update Date : 11/12/2015

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Directions to “ TANYA WOLF ” Practice Location

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