Provider Demographics
NPI:1639484306
Name:JOHN FRENCH LMT, INC.
Entity Type:Organization
Organization Name:JOHN FRENCH LMT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:FRENCH
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:352-494-5552
Mailing Address - Street 1:21915 W NEWBERRY RD
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-2210
Mailing Address - Country:US
Mailing Address - Phone:352-494-5552
Mailing Address - Fax:352-472-2884
Practice Address - Street 1:2114 NW 40TH TER STE C4
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-3592
Practice Address - Country:US
Practice Address - Phone:352-494-5552
Practice Address - Fax:352-472-2884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA29742225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC1238OtherBLUE CROSS AND BLUE SHIELD OF FLORIDA