Provider Demographics
NPI:1922495241
Name:DEBRA MACE
Entity Type:Organization
Organization Name:DEBRA MACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MACE
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:561-351-6225
Mailing Address - Street 1:15357 76TH TRL N
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33418-7316
Mailing Address - Country:US
Mailing Address - Phone:561-351-6225
Mailing Address - Fax:
Practice Address - Street 1:509 US 1
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33403-3573
Practice Address - Country:US
Practice Address - Phone:561-465-1600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA40066251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare