Provider Demographics
NPI:1316189558
Name:ARDELEAN, FLORIAN (LMT)
Entity Type:Individual
Prefix:MR
First Name:FLORIAN
Middle Name:
Last Name:ARDELEAN
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 1:392 FANSHAW J
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3055
Mailing Address - Country:US
Mailing Address - Phone:954-643-4959
Mailing Address - Fax:
Practice Address - Street 1:2900 W SAMPLE RD
Practice Address - Street 2:ACAPULCO 3509/3511
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33073-3024
Practice Address - Country:US
Practice Address - Phone:954-984-5027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA51506225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist