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General NPI Number Information
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NPI Number | 1750039442
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Entity Type | Organization
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Legal Business Name | LYMPHATIC MASSAGE OF FLORIDA LLC
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Dates
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Enumeration Date | 03/13/2022
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Last Update Date | 03/13/2022
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Provider Practice Location Address
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Address Line | 3325 S UNIVERSITY DRIVE SUITE 205
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City | DAVIE
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State | FL
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Zip | 33328
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Country | US
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Telephone | 954-669-0065
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Fax |
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Provider Business Mailing Address
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Address Line | 15750 WOODGATE CT.
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City | SUNRISE
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State | FL
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Zip | 33326
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Country | US
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Telephone | 954-669-0065
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Fax |
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Authorized Official
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Title or Position | ADM. MEMBER
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Name | MRS. MARYURI A. VELAZQUEZ
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Credential | LMT
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Telephone | 954-562-6197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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