Provider Demographics
NPI:1699505537
Name:ESSENCE MASSAGE AND BEAUTY SPA LLC
Entity type:Organization
Organization Name:ESSENCE MASSAGE AND BEAUTY SPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:EMILIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-927-2622
Mailing Address - Street 1:121 LITHIA PINECREST RD STE A
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5346
Mailing Address - Country:US
Mailing Address - Phone:813-381-3161
Mailing Address - Fax:
Practice Address - Street 1:121 LITHIA PINECREST RD STE A
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5346
Practice Address - Country:US
Practice Address - Phone:813-381-3161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty