Provider Demographics
NPI:1356515696
Name:SIEBER, DEBBIE B (LMT)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:B
Last Name:SIEBER
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 1:5584 SUMMERLAND HILLS CIR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33812-6369
Mailing Address - Country:US
Mailing Address - Phone:863-640-3346
Mailing Address - Fax:863-640-3346
Practice Address - Street 1:425 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-5226
Practice Address - Country:US
Practice Address - Phone:863-640-3346
Practice Address - Fax:863-640-3346
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA38709225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC2352OtherBLUE CROSS BLUE SHIELD