Individual
DANA DALE MINICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12461 MORNING GLORY LN, FORT MYERS, FL 33913-8313
(239) 216-2501
Mailing address
12461 MORNING GLORY LN, FORT MYERS, FL 33913-8313
(239) 216-2501
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
1291311
FL
Other
Enumeration date
04/24/2022
Last updated
04/24/2022
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