Provider Demographics
NPI:1821238387
Name:MASSAGE & HEALING CENTER, LLC
Entity Type:Organization
Organization Name:MASSAGE & HEALING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTOYA ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:813-374-9142
Mailing Address - Street 1:PO BOX 263504
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33685-3504
Mailing Address - Country:US
Mailing Address - Phone:813-374-9142
Mailing Address - Fax:813-374-9144
Practice Address - Street 1:1914 N HIMES AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-4219
Practice Address - Country:US
Practice Address - Phone:813-374-9142
Practice Address - Fax:813-374-9144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC7224261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service