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General NPI Number Information
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NPI Number | 1598030157
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Entity Type | Organization
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Legal Business Name | A HEALING THERAPY CENTER OF USA CORP
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Dates
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Enumeration Date | 03/15/2012
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Last Update Date | 03/15/2012
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Provider Practice Location Address
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Address Line | 1140 W 50TH ST STE 205
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City | HIALEAH
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State | FL
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Zip | 33012-3438
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Country | US
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Telephone | 786-558-9352
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Fax |
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Provider Business Mailing Address
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Address Line | 1140 WEST 50 ST SUITE#205
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City | HIALEAH
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State | FL
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Zip | 33012
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Country | US
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Telephone | 786-558-9352
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST
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Name | MR. ANTONIO ESTRADA
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Credential |
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Telephone | 786-558-9352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MM28752
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License Number State | FL
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