Provider Demographics
NPI:1114253481
Name:PURCELL, SAREE MARIE (LMT)
Entity Type:Individual
Prefix:
First Name:SAREE
Middle Name:MARIE
Last Name:PURCELL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:MARIE
Other - Last Name:PURCELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:2053 ARROWGRASS DR UNIT 201
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-4705
Mailing Address - Country:US
Mailing Address - Phone:813-406-5234
Mailing Address - Fax:
Practice Address - Street 1:2053 ARROWGRASS DR UNIT 201
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-4705
Practice Address - Country:US
Practice Address - Phone:813-406-5234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA48711225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist