Provider Demographics
NPI:1588837785
Name:MARGOLIS-GRAY, SUZANNE (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:MARGOLIS-GRAY
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 N MACDILL AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-5126
Mailing Address - Country:US
Mailing Address - Phone:813-871-3200
Mailing Address - Fax:813-877-2640
Practice Address - Street 1:1007 N MACDILL AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-5126
Practice Address - Country:US
Practice Address - Phone:813-871-3200
Practice Address - Fax:813-877-2640
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA7629225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist