Provider Demographics
NPI:1003828112
Name:SERENDIPITY THERAPEUTIC MASSAGE AND BODYWORK, INC.
Entity Type:Organization
Organization Name:SERENDIPITY THERAPEUTIC MASSAGE AND BODYWORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIAANN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:772-781-7494
Mailing Address - Street 1:727 COLORADO AVE
Mailing Address - Street 2:COLORADO PLAZA
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-3017
Mailing Address - Country:US
Mailing Address - Phone:772-781-7494
Mailing Address - Fax:772-781-7491
Practice Address - Street 1:727 COLORADO AVE
Practice Address - Street 2:COLORADO PLAZA
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3017
Practice Address - Country:US
Practice Address - Phone:772-781-7494
Practice Address - Fax:772-781-7491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM17279225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty