MEDICARE: MS. SUSAN MEYER LMT

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	MA25167	FL

General Provider Information

NPI Number	:	1982067856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN MEYER LMT

Provider Business Mailing Address
First Line	:	3418 HANDY RD
Second Line	:	SUITE 201
City	:	TAMPA
State	:	FL
Zip	:	33618-4603
Country	:	US
Telephone Number	:	813-239-4120
Fax Number	:

Provider Business Practice Location Address
First Line	:	3418 HANDY RD
Second Line	:	SUITE 201
City	:	TAMPA
State	:	FL
Zip	:	33618-4603
Country	:	US
Telephone Number	:	813-239-4120
Fax Number	:

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

Provider Enumeration Date	:	03/29/2016
Last Update Date	:	03/29/2016

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