MEDICARE: MISS MARIBEL YARTU LMT

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	MA54821	FL

General Provider Information

NPI Number	:	1487054482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MARIBEL YARTU LMT

Provider Business Mailing Address
First Line	:	3940 SW 2ND TER
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-1727
Country	:	US
Telephone Number	:	305-989-1557
Fax Number	:

Provider Business Practice Location Address
First Line	:	3940 SW 2ND TER
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-1727
Country	:	US
Telephone Number	:	305-989-1557
Fax Number	:

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

Provider Enumeration Date	:	08/26/2014
Last Update Date	:	08/26/2014

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