Provider Demographics
NPI:1285961086
Name:MARIN, ELOY ADALBERTO (MASSAGE THERAPY)
Entity type:Individual
Prefix:MR
First Name:ELOY
Middle Name:ADALBERTO
Last Name:MARIN
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 1:888 NW 27TH AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-3000
Mailing Address - Country:US
Mailing Address - Phone:305-640-8530
Mailing Address - Fax:305-640-8537
Practice Address - Street 1:888 NW 27TH AVE STE 7
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3000
Practice Address - Country:US
Practice Address - Phone:305-640-8530
Practice Address - Fax:305-640-8537
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA337556225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist