Provider Demographics
NPI:1629207790
Name:TESTANI, DIANE (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:
Last Name:TESTANI
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 1:1060 W STATE ROAD 434
Mailing Address - Street 2:SUITE 140
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4919
Mailing Address - Country:US
Mailing Address - Phone:407-924-3758
Mailing Address - Fax:407-331-9006
Practice Address - Street 1:1060 W STATE ROAD 434
Practice Address - Street 2:SUITE 140
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4919
Practice Address - Country:US
Practice Address - Phone:407-924-3758
Practice Address - Fax:407-331-9006
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist