Provider Demographics
NPI:1386670651
Name:GRAVIER, JOSE J SR (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:J
Last Name:GRAVIER
Suffix:SR
Gender:M
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 1:2331 SW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-3109
Mailing Address - Country:US
Mailing Address - Phone:305-541-4725
Mailing Address - Fax:
Practice Address - Street 1:1800 SW 1ST ST STE 216
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1945
Practice Address - Country:US
Practice Address - Phone:305-646-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA8598225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist