Provider Demographics
NPI:1871651877
Name:LEMOS, HAYDEE (PT)
Entity Type:Individual
Prefix:
First Name:HAYDEE
Middle Name:
Last Name:LEMOS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9301 ABBOTT AVE
Mailing Address - Street 2:
Mailing Address - City:SURFSIDE
Mailing Address - State:FL
Mailing Address - Zip Code:33154-2429
Mailing Address - Country:US
Mailing Address - Phone:786-285-5058
Mailing Address - Fax:305-864-2528
Practice Address - Street 1:935 W 49TH ST STE 102 B
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3436
Practice Address - Country:US
Practice Address - Phone:786-285-5058
Practice Address - Fax:305-864-2528
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 18622225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
E7842AMedicare ID - Type Unspecified