OTTER & TROUT TRADING CO INC NPI 1558588905

NPI Information

NPI: 1558588905
Provider Name: OTTER & TROUT TRADING CO INC
Classification: Massage Therapist - 225700000X
Entity Type: Organization
Address:
1135 NW 23RD AVE STE F
GAINESVILLE, FL
ZIP 32609
Phone: (352) 514-2375
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OTTER & TROUT TRADING CO INC is a massage therapist in Gainesville, FL. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. OTTER & TROUT TRADING CO INC NPI is 1558588905. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1135 NW 23RD AVE STE F
GAINESVILLE, FL
ZIP 32609-449
Phone: (352) 514-2375

The provider's authorized official is Kimberli White Otter .
The authorized official title is Ceo (massage Therapist) and has the following contact phone number (352) 485-3599.

The enumeration date for this NPI number is 4/19/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225700000X	Massage Therapist		MA29294	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	C2044	OTHER	FLORIDA	BLUE CROSS PROVIDER #
2	MA29294	OTHER	FLORIDA	MASSAGE THERAPY LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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