Provider Demographics
NPI:1639241722
Name:DENNIS, JOHN CHARLES
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:CHARLES
Last Name:DENNIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5899 WHITFIELD AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-6152
Mailing Address - Country:US
Mailing Address - Phone:941-359-2977
Mailing Address - Fax:941-359-2966
Practice Address - Street 1:4540 BEE RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-2567
Practice Address - Country:US
Practice Address - Phone:941-358-9100
Practice Address - Fax:941-358-9106
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11652225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist