Provider Demographics
NPI:1396058996
Name:ECHEVERRI, SUSANA (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MS
First Name:SUSANA
Middle Name:
Last Name:ECHEVERRI
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8811 SW 132ND PL
Mailing Address - Street 2:#309
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1792
Mailing Address - Country:US
Mailing Address - Phone:305-298-4850
Mailing Address - Fax:
Practice Address - Street 1:8811 SW 132ND PL
Practice Address - Street 2:#309
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1792
Practice Address - Country:US
Practice Address - Phone:305-298-4850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA35468225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist