Provider Demographics
NPI:1124389853
Name:PAREDES, ABRAHAN (LMT)
Entity Type:Individual
Prefix:MR
First Name:ABRAHAN
Middle Name:
Last Name:PAREDES
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3365 SW 1ST CT
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-2307
Mailing Address - Country:US
Mailing Address - Phone:954-821-4907
Mailing Address - Fax:754-227-7777
Practice Address - Street 1:3365 SW 1ST CT
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-2307
Practice Address - Country:US
Practice Address - Phone:954-821-4907
Practice Address - Fax:754-227-7777
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA30866225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist