Individual
MR. EVERILDO VIGISTAIN-RUIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MASSAGE THERAPIST MA
Contact information
Practice address
755 E 9TH ST, HIALEAH, FL 33010-4553
(305) 805-2550
Mailing address
755 E 9TH ST, HIALEAH, FL 33010-4553
(305) 805-2550
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA50948
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA50948
MASSAGE THERAPIST
FL
Enumeration date
12/07/2017
Last updated
12/07/2017
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