Organization
FONG MENTAL & SPIRITUAL MASSAGE THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FERNANDO LORENZO DOMINGUEZ MA 62152 (LICENSED MASSAGE THERAPIST)
(786) 294-0552
Entity
Organization
Contact information
Practice address
4011 W FLAGLER ST, SUITE 406, CORAL GABLES, FL 33134-1643
(786) 294-0552
Mailing address
4011 W FLAGLER ST, SUITE 406, CORAL GABLES, FL 33134-1643
(786) 294-0552
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
62152
FL
Other
Enumeration date
11/02/2011
Last updated
11/04/2011
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