Organization
AG MASSAGE & BODYWORK LLC
Active
Organization
AG MASSAGE & BODYWORK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA GONSALVES LMT, RCA (OWENR)
(407) 720-8511
Entity
Organization
Contact information
Practice address
1985 HOWELL BRANCH RD, MAITLAND, FL 32751-5901
(407) 720-8511
Mailing address
1317 EDGEWATER DR STE 1853, ORLANDO, FL 32804-6350
(407) 720-8511
(407) 612-2272
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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