Provider Demographics
NPI:1871843524
Name:CISMESIA, ANNA LIBERTY
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:LIBERTY
Last Name:CISMESIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:LIBERTY
Other - Last Name:GIANIOTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1814 30TH ST W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-3138
Mailing Address - Country:US
Mailing Address - Phone:941-840-9958
Mailing Address - Fax:
Practice Address - Street 1:1814 30TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-3138
Practice Address - Country:US
Practice Address - Phone:941-840-9958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist