Provider Demographics
NPI:1265046130
Name:MORERA, CLAUDIA ELENA (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:ELENA
Last Name:MORERA
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2241 SW SUSSET LN
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-2334
Mailing Address - Country:US
Mailing Address - Phone:786-683-0996
Mailing Address - Fax:
Practice Address - Street 1:2241 SW SUSSET LN
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-2334
Practice Address - Country:US
Practice Address - Phone:786-683-0996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA46758225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist