Provider Demographics
NPI:1366638652
Name:NIEVAS, PAULA ARLENE (LMT)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:ARLENE
Last Name:NIEVAS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11652 NE 11 PLACE
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161
Mailing Address - Country:US
Mailing Address - Phone:305-525-8612
Mailing Address - Fax:
Practice Address - Street 1:4407 SHERIDAN ST
Practice Address - Street 2:HOLISTIC MASSAGE & WELLNESS CLINICS
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021
Practice Address - Country:US
Practice Address - Phone:954-893-7233
Practice Address - Fax:954-893-5635
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1578694915225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA48642OtherSTATE OF FLORIDA