MEDICARE: EMILY ROSE GARCIA

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	MA79962	FL

General Provider Information

NPI Number	:	1851006126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY ROSE GARCIA

Provider Business Mailing Address
First Line	:	PO BOX 485
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33460-0485
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1739 CARSON AVE
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33460-6033
Country	:	US
Telephone Number	:	561-444-6454
Fax Number	:

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

Provider Enumeration Date	:	01/20/2023
Last Update Date	:	01/20/2023

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