Provider Demographics
NPI:1154674372
Name:BAPTISTA, FREDERICK J (LMT)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:J
Last Name:BAPTISTA
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 1:1800 SW 27TH AVE STE 403
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2400
Mailing Address - Country:US
Mailing Address - Phone:305-603-9388
Mailing Address - Fax:305-982-8137
Practice Address - Street 1:1800 SW 27TH AVE STE 403
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2400
Practice Address - Country:US
Practice Address - Phone:305-603-9388
Practice Address - Fax:305-982-8137
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA66731225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA66731OtherLMT