Provider Demographics
NPI:1255661195
Name:DEJEAN, P.M-DEBORAH (LMT)
Entity Type:Individual
Prefix:MS
First Name:P.M-DEBORAH
Middle Name:
Last Name:DEJEAN
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 1:1300 NE 213TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-1343
Mailing Address - Country:US
Mailing Address - Phone:305-652-6248
Mailing Address - Fax:
Practice Address - Street 1:1300 NE 213TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-1343
Practice Address - Country:US
Practice Address - Phone:305-652-6248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-27
Last Update Date:2009-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA49886225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist