Provider Demographics
NPI:1356794309
Name:DACUNHA, JANE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:JANE
Middle Name:
Last Name:DACUNHA
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 PALM VIEW DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1241
Mailing Address - Country:US
Mailing Address - Phone:239-777-6024
Mailing Address - Fax:
Practice Address - Street 1:5440 PARK CENTRAL CT
Practice Address - Street 2:2
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-6003
Practice Address - Country:US
Practice Address - Phone:239-777-6024
Practice Address - Fax:239-734-3068
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL73980225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist