Provider Demographics
NPI:1255132221
Name:CARLTON, SUMMER LEANN (LMT)
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:LEANN
Last Name:CARLTON
Suffix:
Gender:
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12951 NW 82ND CT
Mailing Address - Street 2:
Mailing Address - City:CHIEFLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32626-4785
Mailing Address - Country:US
Mailing Address - Phone:352-221-2332
Mailing Address - Fax:
Practice Address - Street 1:2469 N YOUNG BLVD STE 6
Practice Address - Street 2:
Practice Address - City:CHIEFLAND
Practice Address - State:FL
Practice Address - Zip Code:32626-9181
Practice Address - Country:US
Practice Address - Phone:352-221-2332
Practice Address - Fax:352-221-2332
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA105818225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist