Provider Demographics
NPI:1235490319
Name:TRINA ELSON LMT PA
Entity Type:Organization
Organization Name:TRINA ELSON LMT PA
Other - Org Name:TEMASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TRINA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ELSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMT PA
Authorized Official - Phone:772-266-4148
Mailing Address - Street 1:701 NW FEDERAL HWY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-1005
Mailing Address - Country:US
Mailing Address - Phone:772-266-4148
Mailing Address - Fax:772-266-4247
Practice Address - Street 1:701 NW FEDERAL HWY
Practice Address - Street 2:SUITE 202
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-1005
Practice Address - Country:US
Practice Address - Phone:772-266-4148
Practice Address - Fax:772-266-4247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 55754174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty