Provider Demographics
NPI:1972802924
Name:GRIMALDI, BARBARA A (LMT)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:A
Last Name:GRIMALDI
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 1:4596 SE GENEVA DR
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-5588
Mailing Address - Country:US
Mailing Address - Phone:561-602-1203
Mailing Address - Fax:772-219-7583
Practice Address - Street 1:4596 SE GENEVA DR
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-5588
Practice Address - Country:US
Practice Address - Phone:561-602-1203
Practice Address - Fax:772-219-7583
Is Sole Proprietor?:No
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA0018898225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist