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General NPI Number Information
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NPI Number | 1619324076
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Entity Type | Organization
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Legal Business Name | VIB VERY INTELLIGENT BODY LLC
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Dates
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Enumeration Date | 05/16/2016
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Last Update Date | 05/16/2016
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Provider Practice Location Address
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Address Line | 1330 CORAL WAY SUITE 102
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City | MIAMI
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State | FL
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Zip | 33145-2929
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Country | US
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Telephone | 786-452-7413
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Fax |
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Provider Business Mailing Address
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Address Line | 951 BRICKELL AVE #4210
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City | MIAMI
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State | FL
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Zip | 33131-3930
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Country | US
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Telephone | 786-302-9764
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. YASMIRA DAHAN
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Credential | LMT
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Telephone | 786-302-9764
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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 | MM32648
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License Number State | FL
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