MEDICARE: CARRIE C DAMASKA

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	MA32716	FL
2	225700000X	Massage Therapist	MM22797	FL

General Provider Information

NPI Number	:	1790995199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE C DAMASKA

Provider Business Mailing Address
First Line	:	3115 W COLUMBUS DR
Second Line	:	SUITE 109
City	:	TAMPA
State	:	FL
Zip	:	33607-1865
Country	:	US
Telephone Number	:	813-374-9530
Fax Number	:	813-374-9541

Provider Business Practice Location Address
First Line	:	3115 W COLUMBUS DR
Second Line	:	SUITE 109
City	:	TAMPA
State	:	FL
Zip	:	33607-1865
Country	:	US
Telephone Number	:	813-374-9530
Fax Number	:	813-374-9541

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

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	02/19/2013

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Directions to “ CARRIE C DAMASKA ” Practice Location

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