Provider Demographics
NPI:1437309432
Name:STEELY, VICTORIA JOAN (LMT, NMT)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:JOAN
Last Name:STEELY
Suffix:
Gender:F
Credentials:LMT, NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 N ORANGE AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4639
Mailing Address - Country:US
Mailing Address - Phone:407-894-0079
Mailing Address - Fax:407-228-6493
Practice Address - Street 1:2909 N ORANGE AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4639
Practice Address - Country:US
Practice Address - Phone:407-894-0079
Practice Address - Fax:407-228-6493
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA0008820225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist