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Individual

MR. EDGAR HERNAN PERILLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
5081 SHERIDAN ST, HOLLYWOOD, FL 33021-2831
(954) 966-1771
Mailing address
5160 SW 40TH AVE APT 5D, FT LAUDERDALE, FL 33314-5751
(954) 303-1526

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA44539
FL

Other

Enumeration date
08/06/2010
Last updated
08/06/2010
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