Provider Demographics
NPI:1043451552
Name:NOILES, SHEILA D (BSN, LMT)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:D
Last Name:NOILES
Suffix:
Gender:F
Credentials:BSN, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 W GRANADA BLVD STE D9
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-9400
Mailing Address - Country:US
Mailing Address - Phone:386-673-1880
Mailing Address - Fax:386-673-1855
Practice Address - Street 1:555 W GRANADA BLVD STE D9
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-9400
Practice Address - Country:US
Practice Address - Phone:386-673-1880
Practice Address - Fax:386-673-1855
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 50432225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist