Provider Demographics
NPI:1558681783
Name:HERRERA, PERLA (PERLA HERRERA LMT)
Entity Type:Individual
Prefix:
First Name:PERLA
Middle Name:
Last Name:HERRERA
Suffix:
Gender:F
Credentials:PERLA HERRERA LMT
Other - Prefix:
Other - First Name:PERLA
Other - Middle Name:
Other - Last Name:HERRERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PERLA HERRERA LMT
Mailing Address - Street 1:14465 SW 138TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7216
Mailing Address - Country:US
Mailing Address - Phone:305-321-3890
Mailing Address - Fax:
Practice Address - Street 1:1450 CORAL WAY
Practice Address - Street 2:# 4
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2856
Practice Address - Country:US
Practice Address - Phone:305-446-7250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL44532225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist