Provider Demographics
NPI:1528826427
Name:HELMS, BOBBY TYLER (LMT)
Entity type:Individual
Prefix:
First Name:BOBBY
Middle Name:TYLER
Last Name:HELMS
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3205 NW 83RD ST APT 2623-C
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-6229
Mailing Address - Country:US
Mailing Address - Phone:386-466-4460
Mailing Address - Fax:
Practice Address - Street 1:4343 NEWBERRY RD STE 4
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2822
Practice Address - Country:US
Practice Address - Phone:352-373-6565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103466225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist