Provider Demographics
NPI:1770803041
Name:PARRIS, CHERRY-ANN MARLENE (LMT)
Entity type:Individual
Prefix:
First Name:CHERRY-ANN
Middle Name:MARLENE
Last Name:PARRIS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 NE 128TH ST
Mailing Address - Street 2:APT 7
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5193
Mailing Address - Country:US
Mailing Address - Phone:786-488-5124
Mailing Address - Fax:
Practice Address - Street 1:570 OCEAN DR
Practice Address - Street 2:#501
Practice Address - City:JUNO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-1952
Practice Address - Country:US
Practice Address - Phone:954-476-6401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 52203225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA52203OtherLICENSED MASSAGE THERAPIST