Dana Louise Cannon
Individual provider Active NPI Massage Therapist · Debary, FL
NPI 1811255680 · NPPES record last updated Apr 30, 2012
Key facts
- NPI
- 1811255680
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MA20613 (FL)
- Practice address
- 17 Canter Club Court
Debary, FL 32713 - Phone
- (386) 668-5999
- NPI assigned
- Apr 30, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA20613 | FL | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA20613 | FL | Yes |
Addresses
Primary practice location
17 Canter Club Court
Debary, FL 32713
Mailing address
17 Canter Club Court
Debary, FL 32713
Phone (386) 668-5999
Other providers in Debary, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.