Provider Demographics
NPI:1083129464
Name:CAMARA, LOURDES (MASSAGE THERAPIST MA)
Entity Type:Individual
Prefix:MS
First Name:LOURDES
Middle Name:
Last Name:CAMARA
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7928 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4209
Mailing Address - Country:US
Mailing Address - Phone:305-261-5000
Mailing Address - Fax:
Practice Address - Street 1:7928 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4209
Practice Address - Country:US
Practice Address - Phone:305-261-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA45804225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA45804OtherMASSAGE THERAPIST