Provider Demographics
NPI:1215542220
Name:HEIGHTS, TREISA (LMT CCE, CME)
Entity Type:Individual
Prefix:MRS
First Name:TREISA
Middle Name:
Last Name:HEIGHTS
Suffix:
Gender:F
Credentials:LMT CCE, CME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2787 E OAKLAND PARK BLVD STE 401
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1632
Mailing Address - Country:US
Mailing Address - Phone:954-305-4454
Mailing Address - Fax:
Practice Address - Street 1:2787 E OAKLAND PARK BLVD STE 401
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1632
Practice Address - Country:US
Practice Address - Phone:954-305-4454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374U00000X
FLMA63179225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No374U00000XNursing Service Related ProvidersHome Health Aide