Individual
CARLOS A MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
4041 13TH ST, SAINT CLOUD, FL 34769-6772
(407) 957-1337
(407) 957-1848
Mailing address
4041 13TH ST, SAINT CLOUD, FL 34769-6772
(407) 957-1337
(407) 957-1848
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
65863
FL
Other
Enumeration date
04/16/2014
Last updated
04/16/2014
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