Provider Demographics
NPI:1235363672
Name:PASIOURTIS, ANDREAS (LMT)
Entity Type:Individual
Prefix:
First Name:ANDREAS
Middle Name:
Last Name:PASIOURTIS
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 1:7121 CAPTIVA CIR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-4070
Mailing Address - Country:US
Mailing Address - Phone:727-858-8690
Mailing Address - Fax:
Practice Address - Street 1:7121 CAPTIVA CIR
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-4070
Practice Address - Country:US
Practice Address - Phone:727-858-8690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA#37922225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist