Rene Callanta, LMT

Individual provider Active NPI Massage Therapist · Edgewater, FL

NPI 1386078749 · NPPES record last updated Aug 21, 2013

Key facts

NPI
1386078749
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
MA69422 (FL)
Practice address
315 N Ridgewood Ave
Edgewater, FL 32132-1617
Phone
(386) 427-8403
Fax
(386) 427-8410
NPI assigned
Aug 21, 2013
Sex
Female
Sole proprietor
No

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
MA69422FLMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA69422 FL Yes

Addresses

Primary practice location

315 N Ridgewood Ave
Edgewater, FL 32132-1617

Mailing address

315 N Ridgewood Ave
Edgewater, FL 32132-1617
Phone (386) 427-8403

Other names

  • Rene Ledoux Former name

Other providers in Edgewater, FL

All providers in Edgewater, FL · Massage Therapist in Florida

Sources for this page

Verify at the official NPI Registry.