MEDICARE: DEBORAH SHENIKA COLLINS 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	MA42523	FL

General Provider Information

NPI Number	:	1225545544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH SHENIKA COLLINS LMT

Provider Business Mailing Address
First Line	:	2315 NW 64TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33147-7754
Country	:	US
Telephone Number	:	305-340-1524
Fax Number	:

Provider Business Practice Location Address
First Line	:	16100 NE 16TH AVE STE B
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-4708
Country	:	US
Telephone Number	:	305-340-1524
Fax Number	:

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

Provider Enumeration Date	:	01/08/2018
Last Update Date	:	01/08/2018

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