Provider Demographics
NPI:1609485036
Name:PRAHASKY, JOYCE ANN (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:ANN
Last Name:PRAHASKY
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 1:1515 DALE MABRY HWY STE 102
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33548-3023
Mailing Address - Country:US
Mailing Address - Phone:813-787-6399
Mailing Address - Fax:
Practice Address - Street 1:1515 DALE MABRY HWY STE 102
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33548-3023
Practice Address - Country:US
Practice Address - Phone:813-515-0369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA61184225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA61184OtherMASSAGE THERAPY