Provider Demographics
NPI:1437216843
Name:KATZ, ROBERTA HELENE (LICENSED MASSAGE THE)
Entity type:Individual
Prefix:MRS
First Name:ROBERTA
Middle Name:HELENE
Last Name:KATZ
Suffix:
Gender:F
Credentials:LICENSED MASSAGE THE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
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Mailing Address - Street 1:7721 NW 120TH DRIVE
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076
Mailing Address - Country:US
Mailing Address - Phone:954-340-9469
Mailing Address - Fax:
Practice Address - Street 1:570 OCEAN DR
Practice Address - Street 2:501 HOLISTIC MASSAGE & WELLNESS CLINICS
Practice Address - City:JUNO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408
Practice Address - Country:US
Practice Address - Phone:954-491-2225
Practice Address - Fax:954-491-6862
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM10479225700000X
FLMM10480225700000X
FLMM10481225700000X
FLMM10482225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist