Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA47334 | FL |
NPI | 1013102946 |
---|---|
Provider Name | Ms. Paula Denise Comellas |
First Address | Oldsmar, FL 34677-2650 |
Second Address | Safety Harbor, FL 34695-3407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2007 |
Last Update Date | 13/09/2007 |