Provider Demographics
NPI:1336678614
Name:LEDFORD, DEBORAH SUZANNE
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:SUZANNE
Last Name:LEDFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BEYOND
Other - Middle Name:MEDICAL
Other - Last Name:TRANSPORT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1162 BARNHORST RD
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-9441
Mailing Address - Country:US
Mailing Address - Phone:863-537-1098
Mailing Address - Fax:863-537-1800
Practice Address - Street 1:1162 BARNHORST RD
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830
Practice Address - Country:US
Practice Address - Phone:863-537-1098
Practice Address - Fax:863-537-1800
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL177274172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver