MEDICARE: ALLEYZEE, INC.

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	MM 21180	FL
2	332B00000X	Durable Medical Equipment & Medical Supplies	2080138847342	FL
3	335E00000X	Prosthetic/Orthotic Supplier	2080138847342	FL

General Provider Information

NPI Number	:	1790967867
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEYZEE, INC.

Provider Business Mailing Address
First Line	:	1679 EAGLE HARBOR PKWY
Second Line	:	SUITE C
City	:	ORANGE PARK
State	:	FL
Zip	:	32003-4816
Country	:	US
Telephone Number	:	904-264-7200
Fax Number	:	904-264-7755

Provider Business Practice Location Address
First Line	:	1679 EAGLE HARBOR PKWY EAST
Second Line	:	SUITE C
City	:	ORANGE PARK
State	:	FL
Zip	:	32003-4816
Country	:	US
Telephone Number	:	904-264-7200
Fax Number	:	904-264-7755

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JEANINE B MAGSITZA
Credential	:
Telephone Number	:	904-264-7200

Provider Enumeration Date	:	11/30/2007
Last Update Date	:	04/01/2009

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Directions to “ALLEYZEE, INC. ” Practice Location

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