Provider Demographics
NPI:1295058097
Name:DUNCAN, DANNA MELYNNE (LMT)
Entity type:Individual
Prefix:
First Name:DANNA
Middle Name:MELYNNE
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1907 MCKINLEY ST
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-3137
Mailing Address - Country:US
Mailing Address - Phone:954-559-4442
Mailing Address - Fax:
Practice Address - Street 1:1907 MCKINLEY ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-3137
Practice Address - Country:US
Practice Address - Phone:954-559-4442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA45768225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA45768OtherLMT