Provider Demographics
NPI:1780456269
Name:NARANJO ALBELO, IVONNE (LMT)
Entity type:Individual
Prefix:
First Name:IVONNE
Middle Name:
Last Name:NARANJO ALBELO
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 1:914 SE 1ST PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-1505
Mailing Address - Country:US
Mailing Address - Phone:239-961-9787
Mailing Address - Fax:
Practice Address - Street 1:4637 VINCENNES BLVD STE 10
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-9110
Practice Address - Country:US
Practice Address - Phone:239-347-3965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA103069225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist