MEDICARE: MASSAGE PEACEFUL 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

General Provider Information

NPI Number	:	1851167142
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MASSAGE PEACEFUL INC

Provider Business Mailing Address
First Line	:	229 DEL PRADO BLVD N STE 10
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33909-2266
Country	:	US
Telephone Number	:	239-347-0710
Fax Number	:

Provider Business Practice Location Address
First Line	:	229 DEL PRADO BLVD N STE 10
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33909-2266
Country	:	US
Telephone Number	:	239-347-0710
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	YANEISY MARTINEZ PINERO
Credential	:
Telephone Number	:	239-347-0710

Provider Enumeration Date	:	11/28/2023
Last Update Date	:	11/28/2023

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