Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA48205 | FL |
N | 226300000X | Kinesiotherapist | MA48205 | FL |
NPI | 1063618189 |
---|---|
Provider Name | Mr. Myron Orlando Sheriff SR. |
First Address | Lauderhill, FL 33319 |
Second Address | Lauderhill, FL 33319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2007 |
Last Update Date | 01/03/2010 |