Healthcare Provider Details

I. General information

NPI: 1316133127
Provider Name (Legal Business Name): ESTHER PALMER MESA LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2007
Last Update Date: 09/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 GIRALDA AVE
CORAL GABLES FL
33134-5208
US

IV. Provider business mailing address

195 GIRALDA AVE
CORAL GABLES FL
33134-5208
US

V. Phone/Fax

Practice location:
  • Phone: 305-567-1973
  • Fax: 305-567-1974
Mailing address:
  • Phone: 305-567-1973
  • Fax: 305-567-1974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA 27668
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: