Provider Demographics
NPI:1578687406
Name:DEMBS, MELODIE (LMT)
Entity type:Individual
Prefix:
First Name:MELODIE
Middle Name:
Last Name:DEMBS
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 1:2840 PROCTOR RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-6444
Mailing Address - Country:US
Mailing Address - Phone:941-376-2782
Mailing Address - Fax:
Practice Address - Street 1:2840 PROCTOR RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-6444
Practice Address - Country:US
Practice Address - Phone:941-376-2782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2008-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA00010590225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist