Provider Demographics
NPI:1093034050
Name:MASHRUWALA, ACHUT (LMT)
Entity Type:Individual
Prefix:MR
First Name:ACHUT
Middle Name:
Last Name:MASHRUWALA
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6155 SCORPIO CIR APT 112
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-6152
Mailing Address - Country:US
Mailing Address - Phone:813-857-5103
Mailing Address - Fax:
Practice Address - Street 1:6155 SCORPIO CIR APT 112
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-6152
Practice Address - Country:US
Practice Address - Phone:813-857-5103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA57802225700000X, 226300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist