Provider Demographics
NPI:1184928855
Name:DUARTE, ALEJANDRO MIGUEL (LMT)
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:MIGUEL
Last Name:DUARTE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3321 SW 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33135-1114
Mailing Address - Country:US
Mailing Address - Phone:786-556-6098
Mailing Address - Fax:
Practice Address - Street 1:3321 SW 1ST ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-1114
Practice Address - Country:US
Practice Address - Phone:786-556-6098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA-60030225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist