Individual
CAROL BERRY TODISCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3084 LAKE WASHINGTON RD, MELBOURNE, FL 32934-7613
(321) 259-5056
Mailing address
3084 LAKE WASHINGTON RD, MELBOURNE, FL 32934-7613
(321) 259-5056
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
42074
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42074
STATE OF FLORIDA DEPT OF
FL
Enumeration date
07/16/2007
Last updated
07/16/2007
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