Provider Demographics
NPI:1255515763
Name:OAKES, RONALD C (LMT)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:C
Last Name:OAKES
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 1:5510 S.W. 54TH STREET
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314
Mailing Address - Country:US
Mailing Address - Phone:954-587-3428
Mailing Address - Fax:
Practice Address - Street 1:4651 SHERIDAN ST
Practice Address - Street 2:SUITE 320
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3457
Practice Address - Country:US
Practice Address - Phone:954-549-3446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15695225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist