Provider Demographics
NPI:1730463043
Name:SINE, CARLA MAY (LMT)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:MAY
Last Name:SINE
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 1:2631 NW 41ST STREET
Mailing Address - Street 2:SUITE E-4
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606
Mailing Address - Country:US
Mailing Address - Phone:352-359-6466
Mailing Address - Fax:
Practice Address - Street 1:2631 NW 41ST ST
Practice Address - Street 2:SUITE E-4
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7470
Practice Address - Country:US
Practice Address - Phone:352-359-6466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA45197225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist