Individual
JOANN SPERANZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T., N.M.T.
Contact information
Practice address
5A FLORIDA PARK DR N, PALM COAST, FL 32137-3806
(386) 447-6633
Mailing address
1764 CASTILE ST, ST AUGUSTINE, FL 32080
(386) 445-6355
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA12923
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C8143
PROVIDER NUMBER
FL
Enumeration date
06/16/2005
Last updated
07/08/2007
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