Provider Demographics
NPI:1780885566
Name:BRUGH, TAMI (LMT)
Entity type:Individual
Prefix:MS
First Name:TAMI
Middle Name:
Last Name:BRUGH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 SPRINGDALE BLVD
Mailing Address - Street 2:BUILDING I UNIT 207
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-6382
Mailing Address - Country:US
Mailing Address - Phone:561-644-7727
Mailing Address - Fax:
Practice Address - Street 1:1937 N MILITARY TRL
Practice Address - Street 2:SUITE D
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-4762
Practice Address - Country:US
Practice Address - Phone:561-687-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA37148225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA37148OtherLMT