Provider Demographics
NPI:1316218613
Name:HONEYWELL, ADRIENNE GATELY (LMT)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:GATELY
Last Name:HONEYWELL
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 1:9225 ULMERTON RD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33771-3751
Mailing Address - Country:US
Mailing Address - Phone:727-386-4004
Mailing Address - Fax:727-386-4090
Practice Address - Street 1:9225 ULMERTON RD
Practice Address - Street 2:SUITE 306
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-3751
Practice Address - Country:US
Practice Address - Phone:727-386-4004
Practice Address - Fax:727-386-4090
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17853225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist