Provider Demographics
NPI:1467210948
Name:WEEKES, CAROLANN
Entity Type:Individual
Prefix:
First Name:CAROLANN
Middle Name:
Last Name:WEEKES
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 1:7635 TIMBERLIN PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-6717
Mailing Address - Country:US
Mailing Address - Phone:646-972-8561
Mailing Address - Fax:
Practice Address - Street 1:7635 TIMBERLIN PARK BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-6717
Practice Address - Country:US
Practice Address - Phone:646-972-8561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist