Provider Demographics
NPI:1053999078
Name:LIVIA, CLAUDIA RAQUEL (LMT)
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:RAQUEL
Last Name:LIVIA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:CLAUDIA
Other - Middle Name:RAQUEL
Other - Last Name:LIVIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:176 SARITA CT
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1644
Mailing Address - Country:US
Mailing Address - Phone:551-313-5902
Mailing Address - Fax:
Practice Address - Street 1:176 SARITA CT
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1644
Practice Address - Country:US
Practice Address - Phone:551-313-5902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-31
Last Update Date:2021-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA96091225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist