Provider Demographics
NPI:1730654450
Name:GARVER, SARA MIRIAM (LMT)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:MIRIAM
Last Name:GARVER
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 1:114 E TARPON AVE # 2
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-3452
Mailing Address - Country:US
Mailing Address - Phone:727-942-4249
Mailing Address - Fax:727-258-2558
Practice Address - Street 1:9 HIBISCUS ST STE 5
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-3436
Practice Address - Country:US
Practice Address - Phone:727-942-4249
Practice Address - Fax:727-258-2558
Is Sole Proprietor?:No
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA51518225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist