MEDICARE: MS. MARY ANN VECCHIO 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	225700000X	Massage Therapist	MA27543	FL
2	2278H0200X	Home Health Certified Respiratory Therapist	TT12658	FL

General Provider Information

NPI Number	:	1588807531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARY ANN VECCHIO LMT

Provider Business Mailing Address
First Line	:	6968 S.W. OLD WIRE RD.
Second Line	:
City	:	FORT WHITE
State	:	FL
Zip	:	32038-4083
Country	:	US
Telephone Number	:	305-298-1219
Fax Number	:	386-497-1677

Provider Business Practice Location Address
First Line	:	6968 S.W. OLD WIRE RD.
Second Line	:
City	:	FORT WHITE
State	:	FL
Zip	:	32038-4083
Country	:	US
Telephone Number	:	305-298-1219
Fax Number	:	386-497-1677

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

Provider Enumeration Date	:	04/07/2009
Last Update Date	:	04/07/2009

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