Provider Demographics
NPI:1053530105
Name:PEREZ, CARMEN B (LICENSE MASSAGE THER)
Entity type:Individual
Prefix:MS
First Name:CARMEN
Middle Name:B
Last Name:PEREZ
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Gender:F
Credentials:LICENSE MASSAGE THER
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Mailing Address - Street 1:2119 WEST DAVIE BOULEVARD
Mailing Address - Street 2:APT 124
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312
Mailing Address - Country:US
Mailing Address - Phone:954-316-4859
Mailing Address - Fax:954-424-0244
Practice Address - Street 1:570 OCEAN DRIVE
Practice Address - Street 2:HOLLISTIC MASSAGE & WELLNESS CLINICS #501
Practice Address - City:JUNO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408
Practice Address - Country:US
Practice Address - Phone:954-491-2225
Practice Address - Fax:954-491-6862
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
FLMA30895225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist