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General NPI Number Information
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NPI Number | 1821369760
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Entity Type | Organization
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Legal Business Name | M&L THERAPEUTIC MASSAGE INC.
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Dates
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Enumeration Date | 01/24/2012
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Last Update Date | 01/24/2012
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Provider Practice Location Address
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Address Line | 6355 SW 8TH ST SUITE#3E
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City | WEST MIAMI
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State | FL
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Zip | 33144-4858
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Country | US
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Telephone | 305-262-2226
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Fax | 305-262-2229
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Provider Business Mailing Address
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Address Line | 6355 SW 8TH ST SUITE#3E
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City | WEST MIAMI
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State | FL
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Zip | 33144-4858
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Country | US
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Telephone | 305-262-2226
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Fax | 305-262-2229
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARIELA LAUZURIQUE
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Credential | M.T.
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Telephone | 305-262-2226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | MA65557
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License Number State | FL
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