MEDICARE: RUTH M NADOLNY MASSAGE THERAPIST

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

General Provider Information

NPI Number	:	1811763030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH M NADOLNY MASSAGE THERAPIST

Provider Business Mailing Address
First Line	:	2000 NE 51ST CT APT 103
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-3741
Country	:	US
Telephone Number	:	184-777-8518
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 NE 51ST CT APT 103
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-3741
Country	:	US
Telephone Number	:	184-777-8518
Fax Number	:

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

Provider Enumeration Date	:	11/29/2023
Last Update Date	:	11/29/2023

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