Provider Demographics
NPI:1568505667
Name:CLOUD 9THERAPEUTIC MASSAGE CORP
Entity Type:Organization
Organization Name:CLOUD 9THERAPEUTIC MASSAGE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:DARIAS
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, CLT
Authorized Official - Phone:305-989-7369
Mailing Address - Street 1:6447 MIAMI LAKES DR E STE 210E
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2765
Mailing Address - Country:US
Mailing Address - Phone:305-989-7369
Mailing Address - Fax:305-362-0002
Practice Address - Street 1:6447 MIAMI LAKES DR E STE 210E
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2765
Practice Address - Country:US
Practice Address - Phone:305-989-7369
Practice Address - Fax:305-362-0002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM14487225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty