Provider Demographics
NPI:1942223391
Name:SANDLER, ELLEN ROBIN (LMT)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:ROBIN
Last Name:SANDLER
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 1:8565 CHARTER CLUB CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-6843
Mailing Address - Country:US
Mailing Address - Phone:239-985-0262
Mailing Address - Fax:
Practice Address - Street 1:11595 KELLY RD # 318
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-2539
Practice Address - Country:US
Practice Address - Phone:239-985-0262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0022021225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist