Provider Demographics
NPI:1487957080
Name:POSADA, EVELYN (MA)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:POSADA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 NW 109TH AVE
Mailing Address - Street 2:APT B 8
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-5217
Mailing Address - Country:US
Mailing Address - Phone:786-715-4133
Mailing Address - Fax:
Practice Address - Street 1:4908 SW 72ND AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-5548
Practice Address - Country:US
Practice Address - Phone:305-662-4646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-21
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA50450225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist