MEDICARE: TISANA BUDHI 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	MA102927	FL

General Provider Information

NPI Number	:	1083399919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TISANA BUDHI LMT

Provider Business Mailing Address
First Line	:	2890 SW 173RD STREET RD
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34473-4115
Country	:	US
Telephone Number	:	407-821-5208
Fax Number	:

Provider Business Practice Location Address
First Line	:	1214 E SILVER SPRINGS BLVD
Second Line	:
City	:	OCALA
State	:	FL
Zip	:	34470-6824
Country	:	US
Telephone Number	:	352-816-3661
Fax Number	:

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

Provider Enumeration Date	:	06/19/2023
Last Update Date	:	06/19/2023

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Directions to “ TISANA BUDHI LMT” Practice Location

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