Provider Demographics
NPI:1265972111
Name:MORNINGSTAR THERAPEUTICS INC
Entity type:Organization
Organization Name:MORNINGSTAR THERAPEUTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CECILE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CANFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:786-402-5753
Mailing Address - Street 1:17639 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-5423
Mailing Address - Country:US
Mailing Address - Phone:786-402-5753
Mailing Address - Fax:480-361-2107
Practice Address - Street 1:17639 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-5423
Practice Address - Country:US
Practice Address - Phone:786-402-5753
Practice Address - Fax:480-361-2107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-26
Last Update Date:2017-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0026805225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1346614609OtherNPI