Provider Demographics
NPI:1528391695
Name:SPATOPIA MASSAGE LLC
Entity Type:Organization
Organization Name:SPATOPIA MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPPELLAZO
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:954-722-4406
Mailing Address - Street 1:5200 N FEDERAL HWY
Mailing Address - Street 2:SUITE 5
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-3253
Mailing Address - Country:US
Mailing Address - Phone:954-772-4406
Mailing Address - Fax:
Practice Address - Street 1:5200 N FEDERAL HWY
Practice Address - Street 2:SUITE 5
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-3253
Practice Address - Country:US
Practice Address - Phone:954-772-4406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM22029225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty