Provider Demographics
NPI:1750937645
Name:MORDEW, DANA M (PT, DPT)
Entity type:Individual
Prefix:MISS
First Name:DANA
Middle Name:M
Last Name:MORDEW
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:M
Other - Last Name:NOCERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1140
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34106-1140
Mailing Address - Country:US
Mailing Address - Phone:239-352-9884
Mailing Address - Fax:239-352-8610
Practice Address - Street 1:5263 GOLDEN GATE PKWY STE E
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-7601
Practice Address - Country:US
Practice Address - Phone:239-352-9884
Practice Address - Fax:239-352-8610
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-15
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT34968225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist