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NPI Code Detail

MEDICARE: NICOLE JENNIFER CORDANO L.M.T.

MEDICARE: NICOLE JENNIFER CORDANO L.M.T.
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
1225700000XMassage Therapist39353FL

General Provider Information

NPI Number : 1740591932
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE JENNIFER CORDANO L.M.T.
Provider Business Mailing Address
First Line : 1101 W KENNEDY BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33606-1900
Country : US
Telephone Number : 727-481-9299
Fax Number :
Provider Business Practice Location Address
First Line : 1101 W KENNEDY BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33606-1900
Country : US
Telephone Number : 727-481-9299
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2010
Last Update Date : 06/23/2010

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