Individual
IVAN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
750 NW 43RD AVE, APT 605, MIAMI, FL 33126-3559
(305) 896-5025
Mailing address
750 NW 43RD AVE, APT 605, MIAMI, FL 33126-3559
(305) 896-5025
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA52337
FL
225700000X
Massage Therapist
MA61381
FL
Other
Enumeration date
04/25/2011
Last updated
04/25/2011
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