Provider Demographics
NPI:1568602506
Name:FALCI, LISA S (LMT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:S
Last Name:FALCI
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 1:5370 NE 17TH TER
Mailing Address - Street 2:SUITE S
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33334-5833
Mailing Address - Country:US
Mailing Address - Phone:954-854-6371
Mailing Address - Fax:
Practice Address - Street 1:5370 NE 17TH TER
Practice Address - Street 2:SUITE S
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33334-5833
Practice Address - Country:US
Practice Address - Phone:954-854-6371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-04
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA 39066OtherLICENSED MASSAGE THERAPIST