Provider Demographics
NPI:1487844916
Name:KOROSI, ANIKO M (LMT)
Entity Type:Individual
Prefix:
First Name:ANIKO
Middle Name:M
Last Name:KOROSI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 ALOMA AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3640
Mailing Address - Country:US
Mailing Address - Phone:407-678-1533
Mailing Address - Fax:407-678-5978
Practice Address - Street 1:2950 ALOMA AVE STE 103
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3640
Practice Address - Country:US
Practice Address - Phone:407-678-1533
Practice Address - Fax:407-678-5978
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA40300225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist