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General NPI Number Information
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NPI Number | 1972894632
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Entity Type | Organization
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Legal Business Name | DORAMEL THERAPY & SPA, LLC
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Dates
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Enumeration Date | 04/28/2011
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Last Update Date | 04/08/2013
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Provider Practice Location Address
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Address Line | 2780 SW 87TH AVE STE 100
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City | MIAMI
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State | FL
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Zip | 33165-3296
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Country | US
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Telephone | 305-222-2281
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Fax |
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Provider Business Mailing Address
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Address Line | 2780 SW 87TH AVE STE 100
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City | MIAMI
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State | FL
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Zip | 33165-3296
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST
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Name | DORA DIAZ
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Credential |
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Telephone | 305-222-2281
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9100070
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT1857
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA37303
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME90883
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License Number State | FL
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