Provider Demographics
NPI:1528002037
Name:VAN BEMMEL, MARIA ELIZABETH (PT)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:ELIZABETH
Last Name:VAN BEMMEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 LANTANA AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33767-1125
Mailing Address - Country:US
Mailing Address - Phone:727-422-4971
Mailing Address - Fax:
Practice Address - Street 1:875 LANTANA AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER BEACH
Practice Address - State:FL
Practice Address - Zip Code:33767-1125
Practice Address - Country:US
Practice Address - Phone:727-422-4971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT9683225100000X
FLMA33423225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist