Individual
IVAN MARCANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2240 SW 70TH AVE STE D, DAVIE, FL 33317-7112
(954) 430-8000
(954) 212-0150
Mailing address
5252 NW 85TH AVE APT 1005, DORAL, FL 33166-5332
(305) 297-9695
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA79241
FL
Other
Enumeration date
04/27/2020
Last updated
04/27/2020
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