Provider Demographics
NPI:1043509011
Name:GABRIELE'S THERAPEUTIC MASSAGE INC
Entity Type:Organization
Organization Name:GABRIELE'S THERAPEUTIC MASSAGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GABRIELE
Authorized Official - Middle Name:BETTINA
Authorized Official - Last Name:KUHN
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:321-431-7864
Mailing Address - Street 1:3026 PARK VILLAGE WAY
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-2266
Mailing Address - Country:US
Mailing Address - Phone:321-431-7864
Mailing Address - Fax:
Practice Address - Street 1:3026 PARK VILLAGE WAY
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-2266
Practice Address - Country:US
Practice Address - Phone:321-431-7864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA-38219225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA-38219OtherMASSAGE THERAPIST