MEDICARE: LUZ BEATRIZ ACOSTA 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	MA57591	FL

General Provider Information

NPI Number	:	1265737944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUZ BEATRIZ ACOSTA LMT

Provider Business Mailing Address
First Line	:	10778 WILES RD
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33076-2009
Country	:	US
Telephone Number	:	954-346-5750
Fax Number	:	954-757-2533

Provider Business Practice Location Address
First Line	:	10778 WILES RD
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33076-2009
Country	:	US
Telephone Number	:	954-346-5750
Fax Number	:	954-757-2533

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

Provider Enumeration Date	:	01/11/2011
Last Update Date	:	01/11/2011

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