Healthcare Provider Details

I. General information

NPI: 1649786401
Provider Name (Legal Business Name): GUZMAR THERAPY MASSAGE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2017
Last Update Date: 01/06/2020
Certification Date: 01/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 FONTAINEBLEAU BLVD STE 2G
MIAMI FL
33172-4511
US

IV. Provider business mailing address

175 FONTAINEBLEAU BLVD STE 2G
MIAMI FL
33172-4511
US

V. Phone/Fax

Practice location:
  • Phone: 305-224-2772
  • Fax: 305-397-2200
Mailing address:
  • Phone: 305-224-2772
  • Fax: 305-397-2200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: MRS. ODALYS MARTINEZ
Title or Position: VICE-PRESIDENT
Credential: LMT
Phone: 305-224-2772