Individual
MRS. KATHLEEN RAE UVARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
1526 GARDEN ST, TITUSVILLE, FL 32796-3268
(321) 267-8141
(321) 385-9142
Mailing address
180 26TH ST, COCOA BEACH, FL 32931-2213
(321) 868-2145
(321) 385-9142
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA13777
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59 3535530
FEDERAL ID
FL
01
—
C7694
BCBS PROVIDER #
FL
Enumeration date
03/26/2007
Last updated
07/08/2007
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