Provider Demographics
NPI:1417235581
Name:GSJ THERAPY CENTER,INC
Entity Type:Organization
Organization Name:GSJ THERAPY CENTER,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:
Authorized Official - Last Name:SUAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:813-850-4519
Mailing Address - Street 1:2090 W BUSCH BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-7568
Mailing Address - Country:US
Mailing Address - Phone:813-644-7232
Mailing Address - Fax:813-443-4653
Practice Address - Street 1:2090 W BUSCH BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7568
Practice Address - Country:US
Practice Address - Phone:813-644-7232
Practice Address - Fax:813-443-4653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-23
Last Update Date:2011-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM27187261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center