Provider Demographics
NPI:1437405230
Name:MEDICAL MASAGE PROFESSIONALS LLC
Entity type:Organization
Organization Name:MEDICAL MASAGE PROFESSIONALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOTELO-PAZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:786-488-8805
Mailing Address - Street 1:7600 S RED RD STE 309
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5427
Mailing Address - Country:US
Mailing Address - Phone:786-488-8805
Mailing Address - Fax:305-547-4191
Practice Address - Street 1:7600 S RED RD STE 309
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5427
Practice Address - Country:US
Practice Address - Phone:786-488-8805
Practice Address - Fax:305-547-4191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA49040225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty