Provider Demographics
NPI:1750309654
Name:EBERMAN, LINDSEY ELIZABETH (MS, ATC, LAT)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ELIZABETH
Last Name:EBERMAN
Suffix:
Gender:F
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5225 NE 2ND CT
Mailing Address - Street 2:APT. 4
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-2856
Mailing Address - Country:US
Mailing Address - Phone:786-261-3582
Mailing Address - Fax:305-348-3571
Practice Address - Street 1:11200 SW 8TH ST
Practice Address - Street 2:UP, ZEB 251A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33199-0001
Practice Address - Country:US
Practice Address - Phone:786-261-3582
Practice Address - Fax:305-348-3571
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 15942255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0270482460OtherPROVIDER INSURANCE
FLAL-1594OtherLICENSE