Provider Demographics
NPI:1720219199
Name:NEMETH, PAULA JANEL (LMT)
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:JANEL
Last Name:NEMETH
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 1:100 PEACH ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:POMONA PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32181-2356
Mailing Address - Country:US
Mailing Address - Phone:386-649-8427
Mailing Address - Fax:
Practice Address - Street 1:676 3RD AVE
Practice Address - Street 2:
Practice Address - City:WELAKA
Practice Address - State:FL
Practice Address - Zip Code:32193
Practice Address - Country:US
Practice Address - Phone:386-467-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA55272172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist