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Individual

MR. JORGE LUIS PARRA JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA

Contact information

Practice address
4851 NW 79 AVE, 10, DORAL, FL 33166-1239
(786) 267-2211
Mailing address
2540 W 8TH CT, HIALEAH, FL 33010-1239
(786) 267-2211

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA59566
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MA59566
MASSAGE THERAPIST
FL
Enumeration date
09/22/2010
Last updated
09/22/2010
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