MEDICARE: MISS MARTHA LUCIA MONTES DE OCA LMT 50396

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	50396	FL

General Provider Information

NPI Number	:	1417154576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MARTHA LUCIA MONTES DE OCA LMT 50396

Provider Business Mailing Address
First Line	:	2740 W 61ST ST
Second Line	:	APT 206
City	:	HIALEAH
State	:	FL
Zip	:	33016-5980
Country	:	US
Telephone Number	:	305-820-8587
Fax Number	:

Provider Business Practice Location Address
First Line	:	2740 W 61ST ST
Second Line	:	APT 206
City	:	HIALEAH
State	:	FL
Zip	:	33016-5980
Country	:	US
Telephone Number	:	305-820-8587
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2007
Last Update Date	:	07/08/2007

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