Individual
MISS MARISOL HEREDIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
18605 SW 100TH AVE, CUTLER BAY, FL 33157-6903
(786) 554-7277
Mailing address
18605 SW 100TH AVE, CUTLER BAY, FL 33157-6903
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA63306
FL
Other
Enumeration date
06/24/2011
Last updated
06/24/2011
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