Provider Demographics
NPI:1114007119
Name:CONTEMPORARY PILATES & MASSAGE, INC
Entity Type:Organization
Organization Name:CONTEMPORARY PILATES & MASSAGE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:A
Authorized Official - Last Name:GIAGONELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-753-0868
Mailing Address - Street 1:2845 ENTERPRISE RD STE 101A
Mailing Address - Street 2:
Mailing Address - City:DEBARY
Mailing Address - State:FL
Mailing Address - Zip Code:32713-2783
Mailing Address - Country:US
Mailing Address - Phone:386-753-0868
Mailing Address - Fax:386-753-0870
Practice Address - Street 1:2845 ENTERPRISE RD STE 101A
Practice Address - Street 2:
Practice Address - City:DEBARY
Practice Address - State:FL
Practice Address - Zip Code:32713-2783
Practice Address - Country:US
Practice Address - Phone:386-753-0868
Practice Address - Fax:386-753-0870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT0002774225100000X
FLMA29772225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty