Provider Demographics
NPI:1629373675
Name:R R THERAPY CLINIC
Entity Type:Organization
Organization Name:R R THERAPY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ELISA
Authorized Official - Last Name:BORRERO
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:813-299-2320
Mailing Address - Street 1:4353 W WATERS AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-8118
Mailing Address - Country:US
Mailing Address - Phone:813-489-4238
Mailing Address - Fax:813-964-3019
Practice Address - Street 1:4353 W WATERS AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-8118
Practice Address - Country:US
Practice Address - Phone:813-489-4238
Practice Address - Fax:813-964-3019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-24
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM 26023225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty