Provider Demographics
NPI:1619267333
Name:PERERA, OFELIA O (LMT)
Entity Type:Individual
Prefix:
First Name:OFELIA
Middle Name:O
Last Name:PERERA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9995 SW 72ND ST
Mailing Address - Street 2:SUITE E 214
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-4662
Mailing Address - Country:US
Mailing Address - Phone:786-558-8461
Mailing Address - Fax:305-513-5748
Practice Address - Street 1:9995 SW 72ND ST
Practice Address - Street 2:SUITE E 214
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-4662
Practice Address - Country:US
Practice Address - Phone:786-558-8461
Practice Address - Fax:305-513-5748
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-14
Last Update Date:2011-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLMA 52391225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist