Provider Demographics
NPI:1851530208
Name:TANDA, MARTA (LMT)
Entity Type:Individual
Prefix:
First Name:MARTA
Middle Name:
Last Name:TANDA
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 1:4854 NW 7TH ST APT 510
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2190
Mailing Address - Country:US
Mailing Address - Phone:305-793-2090
Mailing Address - Fax:
Practice Address - Street 1:4854 NW 7TH ST APT 510
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2190
Practice Address - Country:US
Practice Address - Phone:305-793-2090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA40079225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist