Provider Demographics
NPI:1811257181
Name:MAKINS, ANTHONY HENRY (LMT)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:HENRY
Last Name:MAKINS
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6624 DUVAL AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-6484
Mailing Address - Country:US
Mailing Address - Phone:561-909-5100
Mailing Address - Fax:561-687-2277
Practice Address - Street 1:7750 OKEECHOBEE BLVD
Practice Address - Street 2:SUITE 17
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-2104
Practice Address - Country:US
Practice Address - Phone:561-909-5100
Practice Address - Fax:561-687-2277
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA57063225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist