Healthcare Provider Details

I. General information

NPI: 1881527547
Provider Name (Legal Business Name): TADSON JULIEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2954 NW 135TH ST
OPA LOCKA FL
33054-4860
US

IV. Provider business mailing address

2954 NW 135TH ST
OPA LOCKA FL
33054-4860
US

V. Phone/Fax

Practice location:
  • Phone: 786-704-1156
  • Fax:
Mailing address:
  • Phone: 786-704-1156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA107443
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: