Provider Demographics
NPI:1861367914
Name:LEMAKOS, JACQUELINE (MT-BC)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:
Last Name:LEMAKOS
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 120694
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32912-0694
Mailing Address - Country:US
Mailing Address - Phone:321-209-1071
Mailing Address - Fax:321-256-6424
Practice Address - Street 1:2740 OAK RIDGE CT STE 303
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-9371
Practice Address - Country:US
Practice Address - Phone:321-209-1071
Practice Address - Fax:321-256-6424
Is Sole Proprietor?:No
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17026225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist