Provider Demographics
NPI:1730388489
Name:SCHWARZ, TANIA MEDIANEIRA (LMT, MMP)
Entity type:Individual
Prefix:MRS
First Name:TANIA
Middle Name:MEDIANEIRA
Last Name:SCHWARZ
Suffix:
Gender:F
Credentials:LMT, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 SW ELM GROVE CT
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-2129
Mailing Address - Country:US
Mailing Address - Phone:772-463-5049
Mailing Address - Fax:772-463-2967
Practice Address - Street 1:4243 SW HIGH MEADOWS AVE.
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990
Practice Address - Country:US
Practice Address - Phone:772-219-9877
Practice Address - Fax:772-463-2967
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA48425225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist