Provider Demographics
NPI:1730063819
Name:SUCHAYA THAI MASSAGE LLC
Entity type:Organization
Organization Name:SUCHAYA THAI MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUCHAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONCESSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-939-4565
Mailing Address - Street 1:541 SE WOODS EDGE TRL
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-6374
Mailing Address - Country:US
Mailing Address - Phone:954-939-4565
Mailing Address - Fax:
Practice Address - Street 1:2480 SE FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-4531
Practice Address - Country:US
Practice Address - Phone:772-324-8196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-02
Last Update Date:2025-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1306720545OtherMASSAGE THERAPY