Healthcare Provider Details

I. General information

NPI: 1215169339
Provider Name (Legal Business Name): ARLENE AHNA EYRE LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2009
Last Update Date: 08/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18642 NW 67TH AVE
HIALEAH FL
33015-2406
US

IV. Provider business mailing address

6940 NW 173RD DR UNIT 803
HIALEAH FL
33015-5538
US

V. Phone/Fax

Practice location:
  • Phone: 305-627-5515
  • Fax:
Mailing address:
  • Phone: 305-557-9220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA46270
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: