=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770803041
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHERRY-ANN MARLENE PARRIS LMT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/09/2010
-----------------------------------------------------
Last Update Date | 06/09/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 570 OCEAN DR #501
-----------------------------------------------------
City | JUNO BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33408-1952
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-476-6401
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1215 NE 128TH ST APT 7
-----------------------------------------------------
City | NORTH MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33161-5193
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-488-5124
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | MA 52203
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------