Provider Demographics
NPI:1154487171
Name:FARRETTA, DENNIS PAUL (LMT)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:PAUL
Last Name:FARRETTA
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9850 STIRLING RD
Mailing Address - Street 2:SUITE #102
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-8068
Mailing Address - Country:US
Mailing Address - Phone:954-434-1990
Mailing Address - Fax:954-433-4475
Practice Address - Street 1:9850 STIRLING RD
Practice Address - Street 2:SUITE #102
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-8068
Practice Address - Country:US
Practice Address - Phone:954-434-1990
Practice Address - Fax:954-433-4475
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA0009569225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist