MEDICARE: MS. ELIZABETH ANN BEIRO MASSAGE THERAPIST

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	MA23988	FL

General Provider Information

NPI Number	:	1679626782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH ANN BEIRO MASSAGE THERAPIST

Provider Business Mailing Address
First Line	:	1221 CLEVELAND ST
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33755-4908
Country	:	US
Telephone Number	:	727-467-0775
Fax Number	:	727-467-0774

Provider Business Practice Location Address
First Line	:	1221 CLEVELAND ST
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33755-4908
Country	:	US
Telephone Number	:	727-467-0775
Fax Number	:	727-467-0774

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

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	07/08/2007

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