MEDICARE: WELSPATEA

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	MA54169	FL

General Provider Information

NPI Number	:	1235489329
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELSPATEA

Provider Business Mailing Address
First Line	:	1450 CORAL WAY
Second Line	:	SUITE 4
City	:	MIAMI
State	:	FL
Zip	:	33145-2856
Country	:	US
Telephone Number	:	305-407-9399
Fax Number	:

Provider Business Practice Location Address
First Line	:	1450 CORAL WAY
Second Line	:	SUITE 4
City	:	MIAMI
State	:	FL
Zip	:	33145-2856
Country	:	US
Telephone Number	:	305-407-9399
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. THERESA KIRKSEY
Credential	:	CMT
Telephone Number	:	305-407-9399

Provider Enumeration Date	:	09/15/2012
Last Update Date	:	09/15/2012

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Directions to “WELSPATEA ” Practice Location

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