Provider Demographics
NPI:1306677919
Name:NADEAU, EMILE JUDE (LMT,LPN)
Entity type:Individual
Prefix:
First Name:EMILE
Middle Name:JUDE
Last Name:NADEAU
Suffix:
Gender:M
Credentials:LMT,LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4710 SWANSNECK PL
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-4927
Mailing Address - Country:US
Mailing Address - Phone:407-252-1454
Mailing Address - Fax:
Practice Address - Street 1:4710 SWANSNECK PL
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-4927
Practice Address - Country:US
Practice Address - Phone:407-252-1454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103537225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty