Provider Demographics
NPI:1407154677
Name:DONOVAN, MEGAN ELIZABETH (LMT)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:ELIZABETH
Last Name:DONOVAN
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 1:2100 S TAMIAMI TRL
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-3800
Mailing Address - Country:US
Mailing Address - Phone:941-554-8525
Mailing Address - Fax:941-554-8527
Practice Address - Street 1:2100 S TAMIAMI TRL
Practice Address - Street 2:SUITE 202
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3800
Practice Address - Country:US
Practice Address - Phone:941-554-8525
Practice Address - Fax:941-554-8527
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-11
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA56263225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist