Individual
DENA BEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
5111 N 12TH AVE STE B, PENSACOLA, FL 32504-8918
(808) 756-0503
Mailing address
2210 E MAXWELL ST, PENSACOLA, FL 32503-4951
(808) 756-0503
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2100
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A0234268
HMSA/BCBS
HI
05
—
567208-01
—
HI
01
—
56720800
ALOHACARE
HI
01
—
9221294
UHA
HI
01
—
A016
TRICARE
HI
Enumeration date
11/08/2006
Last updated
09/09/2024
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