Healthcare Provider Details

I. General information

NPI: 1710824206
Provider Name (Legal Business Name): SYDNEY DEAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30941 MILL LN STE B
SPANISH FORT AL
36527-5457
US

IV. Provider business mailing address

301 N BARCELONA ST STE C
PENSACOLA FL
32501-4834
US

V. Phone/Fax

Practice location:
  • Phone: 251-459-0098
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number50169
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: