Provider Demographics
NPI:1255562971
Name:HESS, DANA MARIE (PAC)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:MARIE
Last Name:HESS
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 W ROBERTSON ST
Mailing Address - Street 2:STE 102
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4934
Mailing Address - Country:US
Mailing Address - Phone:813-684-3707
Mailing Address - Fax:813-865-5843
Practice Address - Street 1:721 W ROBERTSON ST
Practice Address - Street 2:STE 102
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4934
Practice Address - Country:US
Practice Address - Phone:813-684-3707
Practice Address - Fax:813-865-5843
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPAT 9105037363AS0400X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical