Provider Demographics
NPI:1447869581
Name:GUEVARA MESA, DAYAMI (LMT)
Entity type:Individual
Prefix:
First Name:DAYAMI
Middle Name:
Last Name:GUEVARA MESA
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 1:8726 NW 26TH ST STE 12
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-1628
Mailing Address - Country:US
Mailing Address - Phone:305-599-0770
Mailing Address - Fax:305-675-0942
Practice Address - Street 1:8726 NW 26TH ST STE 12
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-1628
Practice Address - Country:US
Practice Address - Phone:305-599-0770
Practice Address - Fax:305-675-0942
Is Sole Proprietor?:No
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA67691225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist