Provider Demographics
NPI:1306153036
Name:BROWN, ROBERT ABRAHAM (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ABRAHAM
Last Name:BROWN
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10330 N DALE MABRY HWY STE 201
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-4404
Mailing Address - Country:US
Mailing Address - Phone:813-443-4909
Mailing Address - Fax:813-443-4910
Practice Address - Street 1:10330 N DALE MABRY HWY STE 201
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-4404
Practice Address - Country:US
Practice Address - Phone:813-443-4909
Practice Address - Fax:813-443-4910
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA59982172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist