Organization
LA SALETTE HEALTH AND FITNESS INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARIANNE S CANO M.S.P.T. (PHYSICAL THERAPIST)
(321) 525-5453
Entity
Organization
Contact information
Practice address
105 S RIVERSIDE DR, STE # 150, INDIALANTIC, FL 32903-4365
(321) 525-5453
(866) 810-9307
Mailing address
PO BOX 33265, INDIALANTIC, FL 32903-0265
(321) 525-5453
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
PT-11017
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y5332
BCBS
FL
Enumeration date
08/01/2007
Last updated
06/28/2012
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