Provider Demographics
NPI:1659508778
Name:NORELL, JOSHUA W (LMT)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:W
Last Name:NORELL
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2295 S HIAWASSEE RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-8746
Mailing Address - Country:US
Mailing Address - Phone:407-295-4098
Mailing Address - Fax:
Practice Address - Street 1:2295 S HIAWASSEE RD
Practice Address - Street 2:SUITE 209
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-8746
Practice Address - Country:US
Practice Address - Phone:407-295-4098
Practice Address - Fax:407-295-4078
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 54973225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA54973OtherLMT LICENSE