Provider Demographics
NPI:1659676252
Name:PENADO-CHORENS, AIMEE (LMT)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:PENADO-CHORENS
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 1:809 JOEL BLVD
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-0934
Mailing Address - Country:US
Mailing Address - Phone:239-258-8772
Mailing Address - Fax:
Practice Address - Street 1:809 JOEL BLVD
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-0934
Practice Address - Country:US
Practice Address - Phone:239-440-3266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-13
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 42959225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist