Provider Demographics
NPI:1801829577
Name:NERI, DANA M (RPT)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:M
Last Name:NERI
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 SUNSET LAKE BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-7556
Mailing Address - Country:US
Mailing Address - Phone:941-497-1737
Mailing Address - Fax:941-497-7889
Practice Address - Street 1:836 SUNSET LAKE BLVD STE 201
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-7556
Practice Address - Country:US
Practice Address - Phone:941-497-1737
Practice Address - Fax:941-497-7889
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT5376225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY043VAMedicare ID - Type UnspecifiedMEDICARE PROV NUMBER