Provider Demographics
NPI:1801033154
Name:HUFF, AUDREA (LMT)
Entity Type:Individual
Prefix:
First Name:AUDREA
Middle Name:
Last Name:HUFF
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 1:10131 W COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4221
Mailing Address - Country:US
Mailing Address - Phone:407-292-2156
Mailing Address - Fax:407-241-2859
Practice Address - Street 1:10131 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4221
Practice Address - Country:US
Practice Address - Phone:407-292-2156
Practice Address - Fax:407-241-2859
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 44501225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist