MEDICARE: BODY HEALING THERAPY CENTER, INC.

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	261Q00000X	Clinic/Center	HCC	FL

General Provider Information

NPI Number	:	1447499298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BODY HEALING THERAPY CENTER, INC.

Provider Business Mailing Address
First Line	:	3522 W AZEELE ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-2916
Country	:	US
Telephone Number	:	813-373-5317
Fax Number	:	813-373-5314

Provider Business Practice Location Address
First Line	:	3522 W AZEELE ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-2916
Country	:	US
Telephone Number	:	813-373-5317
Fax Number	:	813-373-5314

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MARIELEN SARMIENTO
Credential	:
Telephone Number	:	813-373-5317

Provider Enumeration Date	:	02/17/2009
Last Update Date	:	02/17/2009

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