Provider Demographics
NPI:1881024370
Name:JENCURA-FISHER, MARIA ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:ANN
Last Name:JENCURA-FISHER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 FOREST LAKES BLVD
Mailing Address - Street 2:#205
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-2300
Mailing Address - Country:US
Mailing Address - Phone:386-689-0710
Mailing Address - Fax:
Practice Address - Street 1:6291 NAPLES BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2030
Practice Address - Country:US
Practice Address - Phone:239-597-0333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-19
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11054111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor