Individual
DIANA TAVARES DE SOUZA BUENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
4400 W SAMPLE RD STE 112, COCONUT CREEK, FL 33073-3457
(954) 914-5997
Mailing address
2240 N CYPRESS BEND DR APT 201, POMPANO BEACH, FL 33069-5609
(954) 914-5997
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA103761
FL
Other
Enumeration date
12/22/2023
Last updated
12/22/2023
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