MEDICARE: CHRISTINA BROADY

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	MA 81552	FL

General Provider Information

NPI Number	:	1639526817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA BROADY

Provider Business Mailing Address
First Line	:	2210 CURLEW RD.
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2210 CURLEW RD
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-6823
Country	:	US
Telephone Number	:	727-372-9500
Fax Number	:

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

Provider Enumeration Date	:	05/18/2016
Last Update Date	:	05/18/2016

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Directions to “ CHRISTINA BROADY ” Practice Location

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