MEDICARE: LENA BETH ANDERSON

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	MA33618	FL

General Provider Information

NPI Number	:	1154656825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LENA BETH ANDERSON

Provider Business Mailing Address
First Line	:	500 NE 2ND ST
Second Line	:	UNIT #124
City	:	DANIA
State	:	FL
Zip	:	33004
Country	:	US
Telephone Number	:	305-522-4022
Fax Number	:

Provider Business Practice Location Address
First Line	:	3020 E COMMERCIAL BLVD
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-4312
Country	:	US
Telephone Number	:	947-772-1919
Fax Number	:

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

Provider Enumeration Date	:	10/13/2009
Last Update Date	:	10/13/2009

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Directions to “ LENA BETH ANDERSON ” Practice Location

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