Provider Demographics
NPI:1841586088
Name:MAC TECHS LLC
Entity type:Organization
Organization Name:MAC TECHS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:CANZIO
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:727-372-9500
Mailing Address - Street 1:1310 SEVEN SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5643
Mailing Address - Country:US
Mailing Address - Phone:727-372-9500
Mailing Address - Fax:727-372-1268
Practice Address - Street 1:1324 SEVEN SPRINGS BLVD
Practice Address - Street 2:SUITE 157
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-5635
Practice Address - Country:US
Practice Address - Phone:727-372-9500
Practice Address - Fax:727-372-1268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA20611261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy