MEDICARE: MRS. PAULA D. COOPER 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	MA0007650	FL

General Provider Information

NPI Number	:	1629120357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PAULA D. COOPER LMT

Provider Business Mailing Address
First Line	:	2832 CHARING CROSS WAY
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32837-9112
Country	:	US
Telephone Number	:	407-438-0065
Fax Number	:	407-438-0065

Provider Business Practice Location Address
First Line	:	1936 LEE RD
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32789-7229
Country	:	US
Telephone Number	:	407-423-0038
Fax Number	:

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

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	05/01/2023

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Directions to “ MRS. PAULA D. COOPER LMT” Practice Location

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