Individual
BETHANY DEROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5255 OLIVET DR, DADE CITY, FL 33523-9039
(352) 737-8888
Mailing address
5255 OLIVET DR, DADE CITY, FL 33523-9039
(352) 737-8888
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
104844
FL
Other
Enumeration date
06/23/2025
Last updated
06/23/2025
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