Provider Demographics
NPI:1144663626
Name:PASIENZA, JANE E (AP DOM)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:E
Last Name:PASIENZA
Suffix:
Gender:F
Credentials:AP DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 76TH ST NW
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-1034
Mailing Address - Country:US
Mailing Address - Phone:941-993-9649
Mailing Address - Fax:941-792-2342
Practice Address - Street 1:2620 MANATEE AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-4944
Practice Address - Country:US
Practice Address - Phone:941-993-9649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3039171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist