Provider Demographics
NPI:1932714151
Name:LAMBERT, MARY (AP, MMP)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:AP, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28520 ALESSANDRIA CIR
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-8273
Mailing Address - Country:US
Mailing Address - Phone:239-248-6124
Mailing Address - Fax:
Practice Address - Street 1:9990 COCONUT RD STE 239
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:34135-8488
Practice Address - Country:US
Practice Address - Phone:239-390-1254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-14
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA81277225700000X
FLAP4490171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist