Individual
MASAE SHIMOMOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
7422 RADIANT CIR, ORLANDO, FL 32810-3136
(718) 290-5658
Mailing address
7422 RADIANT CIR, ORLANDO, FL 32810-3136
(718) 290-5658
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
022991
NY
225700000X
Massage Therapist
Primary
MA95709
FL
Other
Enumeration date
10/20/2020
Last updated
10/20/2020
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