Provider Demographics
NPI:1780216978
Name:BRAYMES, MERELIN (LMT, HHP)
Entity Type:Individual
Prefix:
First Name:MERELIN
Middle Name:
Last Name:BRAYMES
Suffix:
Gender:F
Credentials:LMT, HHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 S SAPODILLA AVE PH 22
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-4182
Mailing Address - Country:US
Mailing Address - Phone:609-705-2355
Mailing Address - Fax:
Practice Address - Street 1:4360 NORTHLAKE BLVD STE 209
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-6265
Practice Address - Country:US
Practice Address - Phone:561-439-6644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA82264225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist