Provider Demographics
NPI:1285164178
Name:DEAMARA, LAUREN (DPT)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:DEAMARA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:SACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1300 HEMPEL AVE
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4668
Mailing Address - Country:US
Mailing Address - Phone:407-296-1900
Mailing Address - Fax:
Practice Address - Street 1:1300 HEMPEL AVE
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4668
Practice Address - Country:US
Practice Address - Phone:407-296-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTT32617225100000X
FLPT32617225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist