Michelle D Bethea, L.M.T.
Individual provider Active NPI Massage Therapist · Perry, FL
NPI 1942520531 · NPPES record last updated Jun 4, 2010
Key facts
- NPI
- 1942520531
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MA31333 (FL)
- Practice address
- 5211 Turner Rd
Perry, FL 32348-8039 - Phone
- (850) 584-2616
- NPI assigned
- Jun 4, 2010
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| MA31333 | FL | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA31333 | FL | Yes |
Addresses
Primary practice location
5211 Turner Rd
Perry, FL 32348-8039
Mailing address
5211 Turner Rd.
Perry, FL 32348
Phone (850) 584-2616
Other providers in Perry, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.