Provider Demographics
NPI:1356468185
Name:ANEZ, PATTY JONTZA (LMT)
Entity Type:Individual
Prefix:MS
First Name:PATTY
Middle Name:JONTZA
Last Name:ANEZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:IRENE
Other - Last Name:ANEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:6116 TOWNCENTER CIR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-9558
Mailing Address - Country:US
Mailing Address - Phone:239-250-6701
Mailing Address - Fax:
Practice Address - Street 1:5051 CASTELLO DR STE 201
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-8985
Practice Address - Country:US
Practice Address - Phone:239-250-6701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 15684225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist