Individual
LINDA S LAZEAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2757 N OCEANSHORE BLVD, FLAGLER BEACH, FL 32136-2745
(386) 316-4689
(386) 517-0046
Mailing address
2757 N OCEANSHORE BLVD, FLAGLER BEACH, FL 32136-2745
(386) 316-4689
(386) 517-0046
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA0018612
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C4165
BLUE CROSS BLUE SHIELD
FL
01
—
MA0018612
STATE LICENSE
FL
Enumeration date
03/15/2007
Last updated
07/08/2007
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