MEDICARE: MR. DANIEL LEWIS DUNN LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MA74756	FL

General Provider Information

NPI Number	:	1265250567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANIEL LEWIS DUNN LMT

Provider Business Mailing Address
First Line	:	3502 HENDERSON BLVD STE 226
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-3999
Country	:	US
Telephone Number	:	818-138-6348
Fax Number	:

Provider Business Practice Location Address
First Line	:	3502 HENDERSON BLVD STE 226
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-3999
Country	:	US
Telephone Number	:	818-138-6348
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2024
Last Update Date	:	09/26/2024

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