Provider Demographics
NPI:1417563065
Name:MONTIEL, ALEJANDRO (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:MONTIEL
Suffix:
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 1:2050 NE 140TH ST APT 22
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33181-1653
Mailing Address - Country:US
Mailing Address - Phone:305-409-6554
Mailing Address - Fax:
Practice Address - Street 1:2050 NE 140TH ST APT 22
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33181-1653
Practice Address - Country:US
Practice Address - Phone:305-409-6554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-18
Last Update Date:2020-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA23857225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist