Provider Demographics
NPI:1063027431
Name:CHAVES, LUZ DANEIRA (MA 57033)
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:DANEIRA
Last Name:CHAVES
Suffix:
Gender:F
Credentials:MA 57033
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10126 NW 3RD PL
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6807
Mailing Address - Country:US
Mailing Address - Phone:954-552-9054
Mailing Address - Fax:
Practice Address - Street 1:10126 NW 3RD PL
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-6807
Practice Address - Country:US
Practice Address - Phone:954-552-9054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-12
Last Update Date:2020-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist