Provider Demographics
NPI:1902103526
Name:MURO, ROLANDO (MA)
Entity Type:Individual
Prefix:
First Name:ROLANDO
Middle Name:
Last Name:MURO
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8360 W FLAGLER ST
Mailing Address - Street 2:110
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2042
Mailing Address - Country:US
Mailing Address - Phone:305-222-6116
Mailing Address - Fax:305-222-6119
Practice Address - Street 1:8360 W FLAGLER ST
Practice Address - Street 2:110
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2042
Practice Address - Country:US
Practice Address - Phone:305-222-6116
Practice Address - Fax:305-222-6119
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA60079225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist