Provider Demographics
NPI:1073149746
Name:WELLBEING THERAPEUTIC SPA LLC
Entity Type:Organization
Organization Name:WELLBEING THERAPEUTIC SPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATOS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:786-554-9471
Mailing Address - Street 1:2314 DEL PRADO BLVD S STE 2
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-6635
Mailing Address - Country:US
Mailing Address - Phone:239-347-3965
Mailing Address - Fax:
Practice Address - Street 1:2314 DEL PRADO BLVD S STE 2
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-6635
Practice Address - Country:US
Practice Address - Phone:239-347-3965
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-13
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty