Organization
LA DE DA BODY SPA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HEATHER LYNN CEGIELSKI LMT,MMP (OWNER/MASSAGE THERAPIST)
(407) 900-5937
Entity
Organization
Contact information
Practice address
2022 E ROBINSON ST, ORLANDO, FL 32803-6045
(407) 900-5937
Mailing address
2022 E ROBINSON ST, ORLANDO, FL 32803-6045
(407) 900-5937
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA78414
FL
261QR0400X
Rehabilitation Clinic/Center
MA78414
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA78414
LMT # MA78414
FL
Enumeration date
12/26/2015
Last updated
12/26/2015
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