MEDICARE: MRS. SABINE M. HOPPER 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	MA 49136	FL

General Provider Information

NPI Number	:	1245583939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SABINE M. HOPPER LMT

Provider Business Mailing Address
First Line	:	PO BOX 127
Second Line	:
City	:	SPARR
State	:	FL
Zip	:	32192-0127
Country	:	US
Telephone Number	:	352-732-4347
Fax Number	:	352-732-4347

Provider Business Practice Location Address
First Line	:	13699 NE 47TH AVE
Second Line	:
City	:	ANTHONY
State	:	FL
Zip	:	32617-2510
Country	:	US
Telephone Number	:	352-732-4347
Fax Number	:	352-732-4347

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

Provider Enumeration Date	:	10/18/2012
Last Update Date	:	10/18/2012

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