Individual
MRS. DORENDA MELLYN MIDDLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRT
Contact information
Practice address
547 NE LAKE DR, LAKE CITY, FL 32055-3446
(386) 438-5493
(386) 438-5493
Mailing address
PO BOX 1952, LAKE CITY, FL 32056-1952
(386) 438-5493
(386) 438-5493
Taxonomy
Speciality
Code
Description
License number
State
227800000X
Certified Respiratory Therapist
Primary
TT003783
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005972000
—
FL
Enumeration date
03/21/2007
Last updated
08/09/2013
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