Provider Demographics
NPI:1124184635
Name:BRAZIS, DOROTHY MARIE (LMT)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:MARIE
Last Name:BRAZIS
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 1:1302 NW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-4131
Mailing Address - Country:US
Mailing Address - Phone:352-359-1737
Mailing Address - Fax:
Practice Address - Street 1:1212 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-3032
Practice Address - Country:US
Practice Address - Phone:352-359-1737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA38210225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist