MEDICARE: MS. HELEN M DALLAIRE 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	MA33308	FL

General Provider Information

NPI Number	:	1487701900
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HELEN M DALLAIRE LMT

Provider Business Mailing Address
First Line	:	PO BOX 587
Second Line	:
City	:	FLORAL CITY
State	:	FL
Zip	:	34436-0587
Country	:	US
Telephone Number	:	352-341-2867
Fax Number	:

Provider Business Practice Location Address
First Line	:	9255 S STARFISH AVE
Second Line	:
City	:	FLORAL CITY
State	:	FL
Zip	:	34436-5603
Country	:	US
Telephone Number	:	352-341-2867
Fax Number	:

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

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	10/01/2007

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