Individual
LISSETT GONZALEZ QUINTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA 93851
Contact information
Practice address
8504 NW 103RD ST, HIALEAH, FL 33016-4870
(786) 420-5111
Mailing address
1245 W 25TH PL APT 3, HIALEAH, FL 33010-1831
(786) 379-3650
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA93851
FL
Other
Enumeration date
09/08/2021
Last updated
09/08/2021
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