Doctor Name: | MS. MARIE V EVANGELISTI |
NPI Number: | 1316122195 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | MA0021344 |
Business Practice Address: | 132 10th Ave N 105 Safety Harbor, FL - 346953407 |
Business Phone Number: | 7277123925 |
Business Fax Number: | 7277233160 |
Mailing Address: | 2400 Winding Creek Blvd, Bldg10-102 CLEARWATER |
State: | FL |
Postal Code: | 337614326 |
Phone Number: | 7277918166 |
Fax Number: | 7277233160 |
NPI Enumeration Date: | 12/30/2007 |
NPI Last Update Date: | 12/30/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA0021344 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |