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Individual

MS. MARIA IZABEL DECAMARGO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6967 SW 115TH PL, UNIT G, MIAMI, FL 33173-1805
(305) 596-5405
Mailing address
6967 SW 115TH PLACE, UNIT G, MIAMI, FL 33173-1890
(786) 291-6059

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA 49871
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MA 49871
MASSAGE THERAPY
FL
Enumeration date
09/08/2009
Last updated
09/08/2009
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