Provider Demographics
NPI:1326279134
Name:BIRON, FAITHEA A (LMT,NMT)
Entity Type:Individual
Prefix:MS
First Name:FAITHEA
Middle Name:A
Last Name:BIRON
Suffix:
Gender:F
Credentials:LMT,NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2426 BEE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-6350
Mailing Address - Country:US
Mailing Address - Phone:941-737-9524
Mailing Address - Fax:941-927-5522
Practice Address - Street 1:2426 BEE RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-6350
Practice Address - Country:US
Practice Address - Phone:941-737-9524
Practice Address - Fax:941-927-5522
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA47779225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist