Provider Demographics
NPI:1720118292
Name:SCHUMAN, DEENA ELAINE (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:DEENA
Middle Name:ELAINE
Last Name:SCHUMAN
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 357700
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32635-7700
Mailing Address - Country:US
Mailing Address - Phone:352-316-5597
Mailing Address - Fax:352-505-6258
Practice Address - Street 1:760 SW 16TH PL
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-8408
Practice Address - Country:US
Practice Address - Phone:352-316-5597
Practice Address - Fax:352-505-6258
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA6632225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA6632OtherMASSAGE LICENSE NUMBER
FLC6296OtherPIN # FOR BLUE CROSS BLUE