MEDICARE: MRS. SANDRA RICHARDSON 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	MA43870	FL

General Provider Information

NPI Number	:	1215944053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SANDRA RICHARDSON LMT

Provider Business Mailing Address
First Line	:	6600 PEACOCK RD APT 203
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34242-2543
Country	:	US
Telephone Number	:	941-284-9770
Fax Number	:	941-346-1385

Provider Business Practice Location Address
First Line	:	2132 GULF GATE DR
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34231-4813
Country	:	US
Telephone Number	:	941-284-9770
Fax Number	:	941-346-1385

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	07/21/2022

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