Provider Demographics
NPI:1992034334
Name:SUTTON, DEBORAH LYNN (PT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LYNN
Last Name:SUTTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:LYNN
Other - Last Name:CABINUM MCKEEL BEASLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2680 FOUNTAIN VIEW CIR
Mailing Address - Street 2:#106
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-2712
Mailing Address - Country:US
Mailing Address - Phone:704-307-0475
Mailing Address - Fax:
Practice Address - Street 1:2680 FOUNTAIN VIEW CIR
Practice Address - Street 2:#106
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2712
Practice Address - Country:US
Practice Address - Phone:704-307-0475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-14
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT23329225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT23329OtherPT LIC #