Individual
LUIS GULLERMO PELAEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
8107 CANTERBURY LAKE BLVD, TAMPA, FL 33619-6681
(813) 374-9142
Mailing address
8107 CANTERBURY LAKE BLVD, TAMPA, FL 33619-6681
(813) 374-9142
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
Primary
MA62313
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA62313
LICENSED MASSAGE THERAPIST
FL
Enumeration date
04/14/2011
Last updated
04/14/2011
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