Basic Information
| Provider Information | |||||||||
| NPI: | 1598898140 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAMBERT | ||||||||
| FirstName: | EDGAR | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | LMT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 120 MEDICAL BLVD | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | SPRING HILL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346090220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3526860086 | ||||||||
| FaxNumber: | 3526842081 | ||||||||
| Practice Location | |||||||||
| Address1: | 120 MEDICAL BLVD | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | SPRING HILL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346090220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3526860086 | ||||||||
| FaxNumber: | 3526842081 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/13/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225700000X | MA46071 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist |
No ID Information.