Provider Demographics
NPI:1831330711
Name:CAPONE, FLORENCE E (LMT)
Entity type:Individual
Prefix:
First Name:FLORENCE
Middle Name:E
Last Name:CAPONE
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:PO BOX 357844
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32635-7844
Mailing Address - Country:US
Mailing Address - Phone:727-470-0067
Mailing Address - Fax:
Practice Address - Street 1:4909 NW 27TH CT
Practice Address - Street 2:SUITE 5B
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-6509
Practice Address - Country:US
Practice Address - Phone:352-377-6008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-23
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA42118225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC2859OtherBLUECROSSBLUESHIELD OF FLORIDA