MEDICARE: AMBER LEE FOXXE L.M.T.

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	172M00000X	Mechanotherapist	MA 53330	FL

General Provider Information

NPI Number	:	1922262468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER LEE FOXXE L.M.T.

Provider Business Mailing Address
First Line	:	450 S HIGHLAND CT
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-7520
Country	:	US
Telephone Number	:	954-594-5855
Fax Number	:

Provider Business Practice Location Address
First Line	:	721 SE 17TH ST STE 104
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33316-2983
Country	:	US
Telephone Number	:	954-765-3200
Fax Number	:

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

Provider Enumeration Date	:	07/14/2008
Last Update Date	:	07/14/2008

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