Individual
ALEXANDER MIRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3660 CENTRAL AVE, SUITE # 7, FORT MYERS, FL 33901-7699
(239) 931-5292
(239) 931-5302
Mailing address
3660 CENTRAL AVE, SUITE # 7, FORT MYERS, FL 33901-7699
(239) 931-5292
(239) 931-5302
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA63547
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA63547
MASSAGE THERAPIST
FL
Enumeration date
09/02/2011
Last updated
08/13/2012
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