MEDICARE: LAURIE MESSINA 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	174400000X	Specialist	MA 14013	FL

General Provider Information

NPI Number	:	1306083548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE MESSINA LMT

Provider Business Mailing Address
First Line	:	133 W 6TH AVE STE C
Second Line	:
City	:	MOUNT DORA
State	:	FL
Zip	:	32757-7621
Country	:	US
Telephone Number	:	352-729-2113
Fax Number	:

Provider Business Practice Location Address
First Line	:	122 S GRANDVIEW ST
Second Line	:
City	:	MOUNT DORA
State	:	FL
Zip	:	32757-6017
Country	:	US
Telephone Number	:	352-729-2113
Fax Number	:

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

Provider Enumeration Date	:	01/09/2009
Last Update Date	:	01/09/2009

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Directions to “ LAURIE MESSINA LMT” Practice Location

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