| NPI | 1740672161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANNETH CLAVIJO President 786-227-2494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: FL MA235512) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: FL MA235512) |
| Enumeration Date | 2015-02-22 |
| Last Update Date | 2015-02-22 |