Provider Demographics
NPI:1053119727
Name:MIDDLETON, DEANNA MAY
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:MAY
Last Name:MIDDLETON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5031 S MOORELAND PT
Mailing Address - Street 2:
Mailing Address - City:HOMOSASSA
Mailing Address - State:FL
Mailing Address - Zip Code:34448-4101
Mailing Address - Country:US
Mailing Address - Phone:352-501-0716
Mailing Address - Fax:
Practice Address - Street 1:8449 SW HIGHWAY 200 STE 141
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34481-9695
Practice Address - Country:US
Practice Address - Phone:352-254-3379
Practice Address - Fax:352-460-4301
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT24151225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist