Provider Demographics
NPI:1477660439
Name:BONE, DONNA LEIGH (LMT)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:LEIGH
Last Name:BONE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:DAWN
Other - Middle Name:
Other - Last Name:BONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:1831 NE 7TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-3752
Mailing Address - Country:US
Mailing Address - Phone:352-373-1241
Mailing Address - Fax:
Practice Address - Street 1:2720 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-2994
Practice Address - Country:US
Practice Address - Phone:352-371-1721
Practice Address - Fax:352-371-1721
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA35744225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC1940OtherBLUE CROSS BLUE SHIELD NO