Kaleah McCoy

Individual provider Active NPI Massage Therapist · Fort White, FL

NPI 1184516585 · NPPES record last updated Jul 18, 2025

Key facts

NPI
1184516585
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
104989 (FL)
Practice address
264 SW Old Niblack Ave
Fort White, FL 32038-3278
Phone
(352) 389-9367
NPI assigned
Jul 18, 2025
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
104989FLMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 104989 FL Yes

Addresses

Primary practice location

264 SW Old Niblack Ave
Fort White, FL 32038-3278

Mailing address

264 SW Old Niblack Ave
Fort White, FL 32038-3278

Other providers in Fort White, FL

All providers in Fort White, FL · Massage Therapist in Florida

Sources for this page

Verify at the official NPI Registry.