MEDICARE: MERELIN BRAYMES LMT, HHP

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	MA82264	FL

General Provider Information

NPI Number	:	1780216978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERELIN BRAYMES LMT, HHP

Provider Business Mailing Address
First Line	:	630 S SAPODILLA AVE PH 22
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-4182
Country	:	US
Telephone Number	:	609-705-2355
Fax Number	:

Provider Business Practice Location Address
First Line	:	4360 NORTHLAKE BLVD STE 209
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-6265
Country	:	US
Telephone Number	:	561-439-6644
Fax Number	:

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

Provider Enumeration Date	:	02/06/2020
Last Update Date	:	02/06/2020

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