Provider Demographics
NPI:1194938985
Name:SANMIGUEL, JENNIFER LEE (LMT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LEE
Last Name:SANMIGUEL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:LEE
Other - Last Name:ALVARADO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:1060 HUNTINGTON CT
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-2944
Mailing Address - Country:US
Mailing Address - Phone:407-928-9379
Mailing Address - Fax:
Practice Address - Street 1:211 W BAY AVE APT C
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4102
Practice Address - Country:US
Practice Address - Phone:407-260-0906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA0027845225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist