Provider Demographics
NPI:1952915464
Name:MINSHEW, KAMLESH (LMT, E-RYT, MA, BA,)
Entity Type:Individual
Prefix:MRS
First Name:KAMLESH
Middle Name:
Last Name:MINSHEW
Suffix:
Gender:F
Credentials:LMT, E-RYT, MA, BA,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 ONYX CT
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086-0362
Mailing Address - Country:US
Mailing Address - Phone:760-580-5013
Mailing Address - Fax:
Practice Address - Street 1:116 ONYX CT
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-0362
Practice Address - Country:US
Practice Address - Phone:760-580-5013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA93144225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000000OtherZEEL