Healthcare Provider Details

I. General information

NPI: 1376820282
Provider Name (Legal Business Name): PAULA H VULCAIN L.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2011
Last Update Date: 11/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 N 14TH CT
HOLLYWOOD FL
33020-2518
US

IV. Provider business mailing address

2111 N 14TH CT
HOLLYWOOD FL
33020-2518
US

V. Phone/Fax

Practice location:
  • Phone: 646-250-2244
  • Fax:
Mailing address:
  • Phone: 646-250-2244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA53375
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: