Provider Demographics
NPI:1114224045
Name:ANGIENIUS MASSAGE
Entity Type:Organization
Organization Name:ANGIENIUS MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELICA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:CARLOZZI
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:352-875-3675
Mailing Address - Street 1:13426 SW 63RD TER
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34473-6886
Mailing Address - Country:US
Mailing Address - Phone:352-875-3675
Mailing Address - Fax:352-240-3867
Practice Address - Street 1:2300 S PINE AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5102
Practice Address - Country:US
Practice Address - Phone:352-875-3675
Practice Address - Fax:352-240-3867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-10
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA58340261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation