Provider Demographics
NPI:1871930735
Name:MORCIEGO, MARIA ELENA (LMT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ELENA
Last Name:MORCIEGO
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 1:640 SW 44TH PL
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-1979
Mailing Address - Country:US
Mailing Address - Phone:786-399-7147
Mailing Address - Fax:
Practice Address - Street 1:640 SW 44TH PL
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1979
Practice Address - Country:US
Practice Address - Phone:786-399-7147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA38466225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist