Provider Demographics
NPI:1003640970
Name:SILENT MOMENT LLC
Entity type:Organization
Organization Name:SILENT MOMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:MASTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-833-1523
Mailing Address - Street 1:15701 COLLINS AVE UNIT 805
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-5392
Mailing Address - Country:US
Mailing Address - Phone:305-833-1523
Mailing Address - Fax:
Practice Address - Street 1:3022 WEDDINGTON RD STE 200
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-6885
Practice Address - Country:US
Practice Address - Phone:704-774-3494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FEEL GOOD AMERICA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-31
Last Update Date:2024-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty