MEDICARE: GABRIELLE PELATTI

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

General Provider Information

NPI Number	:	1285194746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELLE PELATTI

Provider Business Mailing Address
First Line	:	5636 SW 39TH ST
Second Line	:
City	:	WEST PARK
State	:	FL
Zip	:	33023-6120
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5636 SW 39TH ST
Second Line	:
City	:	WEST PARK
State	:	FL
Zip	:	33023-6120
Country	:	US
Telephone Number	:	954-394-6878
Fax Number	:

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

Provider Enumeration Date	:	03/21/2019
Last Update Date	:	03/21/2019

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Directions to “ GABRIELLE PELATTI ” Practice Location

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