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Organization
RONDA PANUCCI MASSAGE, LLC
Active
Organization
RONDA PANUCCI MASSAGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONDA LEE PANUCCI LMT (OWNER)
(850) 683-1125
Entity
Organization
Contact information
Practice address
1078 S FERDON BLVD, SUITE B, CRESTVIEW, FL 32536-4510
(850) 683-1125
(850) 683-0981
Mailing address
PO BOX 204, CRESTVIEW, FL 32536-0204
(850) 683-1125
(850) 683-0981
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA0016952
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C6565
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/10/2007
Last updated
08/22/2020
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