Provider Demographics
NPI:1538672464
Name:ESSIX, SONCIEARAY CHAVELA-AMOY (LMT)
Entity Type:Individual
Prefix:
First Name:SONCIEARAY
Middle Name:CHAVELA-AMOY
Last Name:ESSIX
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N ANDREWS AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-1003
Mailing Address - Country:US
Mailing Address - Phone:561-717-9976
Mailing Address - Fax:
Practice Address - Street 1:200 N ANDREWS AVE STE 101
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-1003
Practice Address - Country:US
Practice Address - Phone:561-717-9976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA81778225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist