Provider Demographics
NPI:1346443512
Name:V R MASSAGE & THERAPY CENTER INC
Entity Type:Organization
Organization Name:V R MASSAGE & THERAPY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:IDALMIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTANO
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:813-884-5390
Mailing Address - Street 1:6632 HANLEY RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-4704
Mailing Address - Country:US
Mailing Address - Phone:813-884-5390
Mailing Address - Fax:813-885-2958
Practice Address - Street 1:6632 HANLEY RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-4704
Practice Address - Country:US
Practice Address - Phone:813-884-5390
Practice Address - Fax:813-885-2958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM19484261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service