Provider Demographics
NPI:1477996510
Name:GOSINE, MARCY NEESHA (LMT)
Entity Type:Individual
Prefix:MISS
First Name:MARCY
Middle Name:NEESHA
Last Name:GOSINE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MISS
Other - First Name:MARCY
Other - Middle Name:NEESHA
Other - Last Name:MOHAMMED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10701 CLEARY BLVD
Mailing Address - Street 2:APT 201
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-6018
Mailing Address - Country:US
Mailing Address - Phone:954-696-8657
Mailing Address - Fax:
Practice Address - Street 1:1111 E BROWARD BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-2011
Practice Address - Country:US
Practice Address - Phone:954-463-5554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA65015225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist