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NPI Code Detail

MEDICARE: ODALYS BARCELO

MEDICARE:   ODALYS  BARCELO
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 TherapistMA95849FL

General Provider Information

NPI Number : 1114684123
Entity Type Code : Individual
Provider Name (Legal Business Name) : ODALYS BARCELO
Provider Business Mailing Address
First Line : 1400 NW 107TH AVE STE 500
Second Line :
City : SWEETWATER
State : FL
Zip : 33172-2746
Country : US
Telephone Number : 305-534-0076
Fax Number :
Provider Business Practice Location Address
First Line : 205 1ST ST S
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33880-3255
Country : US
Telephone Number : 305-534-0076
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2021
Last Update Date : 11/24/2021

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Directions to “ ODALYS BARCELO ” Practice Location

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