Provider Demographics
NPI:1730454299
Name:HERNANDEZ ECHEMENDIA, CLAUDIO (MASSAGE THERAPY)
Entity type:Individual
Prefix:
First Name:CLAUDIO
Middle Name:
Last Name:HERNANDEZ ECHEMENDIA
Suffix:
Gender:M
Credentials:MASSAGE THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7815 SW 24TH ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-6541
Mailing Address - Country:US
Mailing Address - Phone:786-334-5290
Mailing Address - Fax:786-334-5291
Practice Address - Street 1:7815 SW 24TH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6541
Practice Address - Country:US
Practice Address - Phone:786-334-5290
Practice Address - Fax:786-334-5291
Is Sole Proprietor?:No
Enumeration Date:2012-03-16
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA63832225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA63832OtherMASSAGE THERAPY LICENCE