Provider Demographics
NPI:1447669734
Name:DREAMSCAPE MASSAGE LLC
Entity type:Organization
Organization Name:DREAMSCAPE MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:SPECHT
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:941-681-0039
Mailing Address - Street 1:1 DOVER DR
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-4637
Mailing Address - Country:US
Mailing Address - Phone:941-681-0039
Mailing Address - Fax:
Practice Address - Street 1:1540 S MCCALL RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-4846
Practice Address - Country:US
Practice Address - Phone:941-681-0039
Practice Address - Fax:941-460-0935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15766225700000X
FLMA86858225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty