Organization
HYDE PARK MASSAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUDSON RANDALL LMT (SOLE PROPRIETOR)
(813) 244-4760
Entity
Organization
Contact information
Practice address
412 S HOWARD AVE, TAMPA, FL 33606-1770
(813) 244-4760
Mailing address
412 S HOWARD AVE, TAMPA, FL 33606-1770
(813) 244-4760
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
MA44083
FL
Other
Enumeration date
11/26/2010
Last updated
11/26/2010
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