Provider Demographics
NPI:1245583939
Name:HOPPER, SABINE M (LMT)
Entity Type:Individual
Prefix:MRS
First Name:SABINE
Middle Name:M
Last Name:HOPPER
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 127
Mailing Address - Street 2:
Mailing Address - City:SPARR
Mailing Address - State:FL
Mailing Address - Zip Code:32192-0127
Mailing Address - Country:US
Mailing Address - Phone:352-732-4347
Mailing Address - Fax:352-732-4347
Practice Address - Street 1:13699 NE 47TH AVE
Practice Address - Street 2:
Practice Address - City:ANTHONY
Practice Address - State:FL
Practice Address - Zip Code:32617-2510
Practice Address - Country:US
Practice Address - Phone:352-732-4347
Practice Address - Fax:352-732-4347
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 49136225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist