Individual
DEXTER PENARANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5820 HARBORAGE DR, FORT MYERS, FL 33908-4549
(239) 462-2278
Mailing address
5820 HARBORAGE DR, FORT MYERS, FL 33908-4549
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19144
LICENSE#
FL
Enumeration date
07/02/2007
Last updated
08/17/2011
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