Provider Demographics
NPI:1417287533
Name:BELUSKO, ALICE (LMT)
Entity type:Individual
Prefix:MISS
First Name:ALICE
Middle Name:
Last Name:BELUSKO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SW 96TH TER APT 203
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2339
Mailing Address - Country:US
Mailing Address - Phone:954-236-5123
Mailing Address - Fax:
Practice Address - Street 1:101 SW 96TH TER APT 203
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2339
Practice Address - Country:US
Practice Address - Phone:954-236-5123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA0028780225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist