Provider Demographics
NPI:1093565863
Name:MALAGON, GREISY (LMT)
Entity Type:Individual
Prefix:
First Name:GREISY
Middle Name:
Last Name:MALAGON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:GREISY
Other - Middle Name:
Other - Last Name:MALAGON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:3380 NW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4104
Mailing Address - Country:US
Mailing Address - Phone:305-501-0426
Mailing Address - Fax:305-777-7121
Practice Address - Street 1:3380 NW 7TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4104
Practice Address - Country:US
Practice Address - Phone:305-501-0426
Practice Address - Fax:305-777-7121
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA49364225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist