MEDICARE: BRIANNA LYNN HESTER MT

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	MA102453	FL

General Provider Information

NPI Number	:	1619725694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA LYNN HESTER MT

Provider Business Mailing Address
First Line	:	5236 CORD AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32209-3172
Country	:	US
Telephone Number	:	904-582-9821
Fax Number	:

Provider Business Practice Location Address
First Line	:	4465 US HIGHWAY 17
Second Line	:
City	:	FLEMING ISLAND
State	:	FL
Zip	:	32003-4800
Country	:	US
Telephone Number	:	904-582-9821
Fax Number	:

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

Provider Enumeration Date	:	05/07/2024
Last Update Date	:	01/03/2025

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