Provider Demographics
NPI:1194926105
Name:TERRELONGE, ARMANDO (LMT)
Entity type:Individual
Prefix:
First Name:ARMANDO
Middle Name:
Last Name:TERRELONGE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 263096
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33685-3096
Mailing Address - Country:US
Mailing Address - Phone:813-849-0222
Mailing Address - Fax:813-849-0185
Practice Address - Street 1:5522 HANLEY RD
Practice Address - Street 2:SUITE 112
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-4902
Practice Address - Country:US
Practice Address - Phone:813-849-0222
Practice Address - Fax:813-849-0185
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 34301225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist