Provider Demographics
NPI:1629332580
Name:SPARKS, LINDSAY ALENA (LMT)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:ALENA
Last Name:SPARKS
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 1:2730 NW 39TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-2263
Mailing Address - Country:US
Mailing Address - Phone:727-945-2996
Mailing Address - Fax:352-376-1320
Practice Address - Street 1:2730 NW 39TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-2263
Practice Address - Country:US
Practice Address - Phone:727-945-2996
Practice Address - Fax:352-376-1320
Is Sole Proprietor?:No
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL60823225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist