Individual
MR. AVI ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICENSED MASSAGE THE
Contact information
Practice address
570 OCEAN DRIVE, HOLISTIC MASSAGE & WELLNESS CLINICS #501, JUNO BEACH, FL 33408
(954) 491-2225
(954) 491-6862
Mailing address
1050 SW 9TH ST, FORT LAUDERDALE, FL 33315
(954) 522-3212
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA32722
LICENSE NUMBER
FL
Enumeration date
04/18/2007
Last updated
07/08/2007
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