Provider Demographics
NPI:1346448024
Name:NADEAU-MORIN, PAMELA DENISE (MSPT)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:DENISE
Last Name:NADEAU-MORIN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 WELLNESS WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-3783
Mailing Address - Country:US
Mailing Address - Phone:772-562-6401
Mailing Address - Fax:772-562-6011
Practice Address - Street 1:801 WELLNESS WAY STE 100
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3783
Practice Address - Country:US
Practice Address - Phone:772-569-0751
Practice Address - Fax:772-388-1659
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT12286225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT12286OtherPT LICENSE