Healthcare Provider Details

I. General information

NPI: 1649578253
Provider Name (Legal Business Name): CINDY MIRIE YEPES L.M.T
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2011
Last Update Date: 03/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

248 LELAND LN
GREENACRES FL
33463-5239
US

IV. Provider business mailing address

248 LELAND LN
GREENACRES FL
33463-5239
US

V. Phone/Fax

Practice location:
  • Phone: 561-827-1001
  • Fax:
Mailing address:
  • Phone: 561-827-1001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA59156
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: