Provider Demographics
NPI:1982616702
Name:NEUMAYER, GLADYS COROMOTO (MT)
Entity Type:Individual
Prefix:MRS
First Name:GLADYS
Middle Name:COROMOTO
Last Name:NEUMAYER
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5111 RIDGEWAY DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7428
Mailing Address - Country:US
Mailing Address - Phone:407-923-7950
Mailing Address - Fax:407-926-0736
Practice Address - Street 1:5111 RIDGEWAY DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7428
Practice Address - Country:US
Practice Address - Phone:407-923-7950
Practice Address - Fax:407-926-0736
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL34391225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist