Individual
MR. MITCHELL JAY RUDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
11620 NW 28TH ST, CORAL SPRINGS, FL 33065-3490
(954) 255-9262
Mailing address
11620 NW 28TH ST, CORAL SPRINGS, FL 33065-3490
(954) 255-9262
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA19369
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA19369
LICENSED MASSAGE THERAPIS
FL
Enumeration date
07/26/2006
Last updated
07/08/2007
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