| Keith Alexander Vidal, | |
|
11321 Torchwood Ct, Wellington, FL 33414-6024 | |
| (757) 231-6717 | |
| Not Available |
| Full Name | Keith Alexander Vidal |
|---|---|
| Gender | Male |
| Speciality | Massage Therapist |
| Location | 11321 Torchwood Ct, Wellington, Florida |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063189835 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225700000X | Massage Therapist | MA97864 (Florida) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Keith Alexander Vidal, Po Box 212041, Royal Palm Beach, FL 33421-2041 Ph: (757) 231-6717 | Keith Alexander Vidal, 11321 Torchwood Ct, Wellington, FL 33414-6024 Ph: (757) 231-6717 |
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