Provider Demographics
NPI:1174836076
Name:GARCIA, MELISSA ESPERANZA (LMT)
Entity Type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:ESPERANZA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3911 W WATERS AVE
Mailing Address - Street 2:SUITE 12
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-1950
Mailing Address - Country:US
Mailing Address - Phone:813-935-1340
Mailing Address - Fax:813-935-1405
Practice Address - Street 1:3911 W WATERS AVE
Practice Address - Street 2:SUITE 12
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-1950
Practice Address - Country:US
Practice Address - Phone:813-935-1340
Practice Address - Fax:813-935-1405
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 59356225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist