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General NPI Number Information
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NPI Number | 1659645455
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Entity Type | Individual
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Provider Name | ERNESTO TENDERO THERAPIST
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Gender | Male
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Dates
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Enumeration Date | 02/27/2012
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Last Update Date | 02/27/2012
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Provider Practice Location Address
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Address Line | 6405 NW 36TH ST STE 112
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City | VIRGINIA GARDENS
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State | FL
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Zip | 33166-6977
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Country | US
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Telephone | 305-962-1737
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Fax | 305-870-0772
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Provider Business Mailing Address
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Address Line | 12291 SW 207TH TER
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City | MIAMI
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State | FL
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Zip | 33177-5665
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Country | US
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Telephone | 305-962-1737
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Fax | 305-870-0772
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | MA45597
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License Number State | FL
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