Provider Demographics
NPI:1659554475
Name:CAREY, NORANDA LEIGH (LMT)
Entity Type:Individual
Prefix:
First Name:NORANDA
Middle Name:LEIGH
Last Name:CAREY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:NORANDA
Other - Middle Name:
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:621 SW LAMBOY CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32024-4255
Mailing Address - Country:US
Mailing Address - Phone:386-344-4248
Mailing Address - Fax:
Practice Address - Street 1:621 SW LAMBOY CIR
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32024-4255
Practice Address - Country:US
Practice Address - Phone:386-344-4248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-15
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL46267225700000X
FL172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist