MEDICARE: MRS. DONNA-LEE GIOIA 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	MA0021645	FL

General Provider Information

NPI Number	:	1689879504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DONNA-LEE GIOIA LMT

Provider Business Mailing Address
First Line	:	1894 SE PORT ST LUCIE BLVD
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-5545
Country	:	US
Telephone Number	:	772-398-1433
Fax Number	:

Provider Business Practice Location Address
First Line	:	1894 SE PORT ST LUCIE BLVD
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-5545
Country	:	US
Telephone Number	:	772-398-1433
Fax Number	:

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

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	07/08/2008

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