Provider Demographics
NPI:1225193220
Name:FERNANDES, ANNE F (LMT)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:F
Last Name:FERNANDES
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:PO BOX 5068
Mailing Address - Street 2:
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33074-5068
Mailing Address - Country:US
Mailing Address - Phone:954-943-6348
Mailing Address - Fax:954-943-0228
Practice Address - Street 1:760 W SAMPLE RD
Practice Address - Street 2:#9
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-2768
Practice Address - Country:US
Practice Address - Phone:954-943-6348
Practice Address - Fax:954-943-0228
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA44055225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist