Provider Demographics
NPI:1568767622
Name:DENNY, SARA (LMT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:DENNY
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:PO BOX 1026
Mailing Address - Street 2:
Mailing Address - City:FLORAL CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34436-1026
Mailing Address - Country:US
Mailing Address - Phone:352-423-0785
Mailing Address - Fax:
Practice Address - Street 1:661 S BROAD ST STE A
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-2844
Practice Address - Country:US
Practice Address - Phone:352-423-0785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA59732225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist