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Individual

MRS. MARISOL LEGON PEREZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
250 NE 191ST ST, APT 3004 A, MIAMI, FL 33179-3889
(786) 306-2592
Mailing address
250 NE 191ST ST, APT 3004 A, MIAMI, FL 33179-3889
(786) 306-2592

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 51704
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MA 51704
LICENSE MASSAGE THERAPIST
FL
Enumeration date
09/25/2008
Last updated
09/25/2008
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