| NPI | 1972287027 |
|---|---|
| Doing Business As | FOUNTAIN OF YOUTH THERAPIES |
| Entity Type | Organization |
| Authorized Contact | SIDNEY L JIMENEZ Licensed Medical Massage Therapist 407-508-0768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225700000X Massage Therapist |
| Additional Taxonomies | 111NR0400X |
| 163WM1400X Registered Nurse, Nurse Massage Therapist (NMT) | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| Enumeration Date | 2023-06-09 |
| Last Update Date | 2024-06-03 |