Healthcare Provider Details

I. General information

NPI: 1720924244
Provider Name (Legal Business Name): MARANGELY OTERO LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1581 W 49TH ST # 81
HIALEAH FL
33012-2924
US

IV. Provider business mailing address

1581 W 49TH ST # 81
HIALEAH FL
33012-2924
US

V. Phone/Fax

Practice location:
  • Phone: 305-600-7134
  • Fax:
Mailing address:
  • Phone: 305-600-7134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA105772
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: