Individual
JUAN CARLOS FLEITAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA 67136
Contact information
Practice address
1900 MAIN ST STE 108, SARASOTA, FL 34236-5950
(941) 592-4393
Mailing address
1660 55TH AVENUE CIR E APT 203, BRADENTON, FL 34203-4483
(941) 592-4393
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA67136
FL
225700000X
Massage Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MA67136
—
FL
Enumeration date
01/26/2020
Last updated
01/26/2020
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