Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA25782 | FL |
NPI | 1023142387 |
---|---|
Provider Name | Mr. Michel Perez |
First Address | Miami, FL 33186-1277 |
Second Address | Miami, FL 33186-1277 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2007 |
Last Update Date | 08/07/2007 |