MEDICARE: SUSAN M CITTA 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	MA31614	FL

General Provider Information

NPI Number	:	1083843395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN M CITTA LMT

Provider Business Mailing Address
First Line	:	351 PRESTWICK CIR
Second Line	:	UNIT 2
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-8426
Country	:	US
Telephone Number	:	561-373-0196
Fax Number	:

Provider Business Practice Location Address
First Line	:	1216 US HIGHWAY 1
Second Line	:	SUITE A
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-3537
Country	:	US
Telephone Number	:	561-373-0196
Fax Number	:

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

Provider Enumeration Date	:	07/08/2009
Last Update Date	:	07/08/2009

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