MEDICARE: MISS NORMA L GRILLO NODA 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	89567	FL

General Provider Information

NPI Number	:	1881186039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS NORMA L GRILLO NODA MASSAGE THERAPIST

Provider Business Mailing Address
First Line	:	460 PALO ALTO DR
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33461-1518
Country	:	US
Telephone Number	:	561-932-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	2240 PALM BEACH LAKES BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-3410
Country	:	US
Telephone Number	:	561-932-8400
Fax Number	:

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

Provider Enumeration Date	:	06/04/2018
Last Update Date	:	06/04/2018

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