Provider Demographics
NPI:1780978387
Name:THERAPEUTIC MASSAGE ESSENTIALS LLC
Entity type:Organization
Organization Name:THERAPEUTIC MASSAGE ESSENTIALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:GUY
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:754-234-8316
Mailing Address - Street 1:888 N ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-1015
Mailing Address - Country:US
Mailing Address - Phone:754-234-8316
Mailing Address - Fax:
Practice Address - Street 1:888 N ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-1015
Practice Address - Country:US
Practice Address - Phone:754-234-8316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 2300171100000X
FLMA54016225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty