Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA76986 | FL |
NPI | 1003492604 |
---|---|
Provider Name | Nilda Cristina Peoles |
First Address | Miami Beach, FL 33139-8677 |
Second Address | Miami Beach, FL 33139-8677 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2021 |
Last Update Date | 23/03/2021 |