MEDICARE: MARIA C PANTIGA

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	MA66254	FL

General Provider Information

NPI Number	:	1538433693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA C PANTIGA

Provider Business Mailing Address
First Line	:	500 W 12TH ST
Second Line	:	APT 10A
City	:	HIALEAH
State	:	FL
Zip	:	33010-7906
Country	:	US
Telephone Number	:	786-718-5187
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 W 12TH ST
Second Line	:	APT 10A
City	:	HIALEAH
State	:	FL
Zip	:	33010-7906
Country	:	US
Telephone Number	:	786-718-5187
Fax Number	:

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

Provider Enumeration Date	:	03/06/2012
Last Update Date	:	03/06/2012

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Directions to “ MARIA C PANTIGA ” Practice Location

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