Provider Demographics
NPI:1326128182
Name:MEYER, ANNEKE
Entity Type:Individual
Prefix:MRS
First Name:ANNEKE
Middle Name:
Last Name:MEYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 GUAVA ISLE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33315-1352
Mailing Address - Country:US
Mailing Address - Phone:954-296-2250
Mailing Address - Fax:
Practice Address - Street 1:1200 GUAVA ISLE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33315-1352
Practice Address - Country:US
Practice Address - Phone:954-296-2250
Practice Address - Fax:754-312-6080
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2022-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT5567225X00000X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL884133100Medicaid