Provider Demographics
NPI:1154030997
Name:MONFORTE, VINCENT IV (LMT)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:
Last Name:MONFORTE
Suffix:IV
Gender:M
Credentials:LMT
Other - Prefix:MR
Other - First Name:VINCENT
Other - Middle Name:
Other - Last Name:MONFORTE
Other - Suffix:IV
Other - Last Name Type:Professional Name
Other - Credentials:V TOUCH MASSAGE INC
Mailing Address - Street 1:8400 TRENT CT APT D
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-8345
Mailing Address - Country:US
Mailing Address - Phone:305-389-5861
Mailing Address - Fax:
Practice Address - Street 1:1881 NE 26TH ST STE 200
Practice Address - Street 2:
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33305-1427
Practice Address - Country:US
Practice Address - Phone:305-389-5861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA51626225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA51626Medicaid