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NPI Code Detail

MEDICARE: MS. JENNEFER LEAH KOLINAC LMT

MEDICARE: MS. JENNEFER LEAH KOLINAC 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
1174400000XSpecialistMA 34385FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MA34385OTHERFLMASSAGE THERAPY

General Provider Information

NPI Number : 1194966986
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JENNEFER LEAH KOLINAC LMT
Provider Business Mailing Address
First Line : 1299 SW 13TH PL
Second Line :
City : BOCA RATON
State : FL
Zip : 33486-5372
Country : US
Telephone Number : 561-445-0360
Fax Number :
Provider Business Practice Location Address
First Line : 2200 NW 2ND AVE
Second Line :
City : BOCA RATON
State : FL
Zip : 33431-7412
Country : US
Telephone Number : 561-445-0360
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2009
Last Update Date : 03/09/2009

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