Provider Demographics
NPI:1205859626
Name:STRASSER, FREDRIKA MARIE (LMT)
Entity Type:Individual
Prefix:MS
First Name:FREDRIKA
Middle Name:MARIE
Last Name:STRASSER
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 1:1007 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-6315
Mailing Address - Country:US
Mailing Address - Phone:321-277-3604
Mailing Address - Fax:407-644-0338
Practice Address - Street 1:1007 GROVE ST
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-6315
Practice Address - Country:US
Practice Address - Phone:321-277-3604
Practice Address - Fax:407-644-0338
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA21986174400000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered174400000XOther Service ProvidersSpecialist
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL041760OtherNCTMB
FLMA21986OtherFLORIDA MASSAGE LICENSE
FLC2604OtherBLUECROSS/BLUESHIELD
FL49270OtherAMER MASSAGE THERAPY ASSO