MEDICARE: SARASOTA THERAPEUTIC MASSAGE

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	:	1457168247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARASOTA THERAPEUTIC MASSAGE

Provider Business Mailing Address
First Line	:	4863 PASTEL CT
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34240-2529
Country	:	US
Telephone Number	:	614-315-6115
Fax Number	:

Provider Business Practice Location Address
First Line	:	5632 BEE RIDGE RD STE 101
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34233-1506
Country	:	US
Telephone Number	:	941-378-9959
Fax Number	:

Authorized Official
Title or Position	:	LICENSED MASSAGE THERAPIST
Name	:	MICHELLE WOLF
Credential	:	LMT
Telephone Number	:	614-315-6115

Provider Enumeration Date	:	12/16/2024
Last Update Date	:	12/16/2024

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Directions to “SARASOTA THERAPEUTIC MASSAGE ” Practice Location

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