Individual
MAGALY PAEZ DICANIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.P., D.O.M.,LMT
Contact information
Practice address
1323 W BUSCH BLVD, SUITE A, TAMPA, FL 33612-7766
(813) 931-9311
(813) 249-1544
Mailing address
1323 W BUSCH BLVD, SUITE A, TAMPA, FL 33612-7766
(813) 931-9311
(813) 249-1544
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP 579
FL
225700000X
Massage Therapist
MA 40826
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C0259
BLUE CROSS BLUE SHIELD
FL
01
—
C0496
BLUE CROSS BLUE SHIELD
FL
01
—
C2736
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/12/2006
Last updated
06/21/2010
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