Provider Demographics
NPI:1063972065
Name:KILMER, ADAM T (MASAGE THERAPIST)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:T
Last Name:KILMER
Suffix:
Gender:M
Credentials:MASAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8902 SW 113TH PLACE CIR E
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1176
Mailing Address - Country:US
Mailing Address - Phone:305-401-1199
Mailing Address - Fax:
Practice Address - Street 1:8902 SW 113TH PLACE CIR E
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1176
Practice Address - Country:US
Practice Address - Phone:305-401-1199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL82048225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist