Provider Demographics
NPI:1447568654
Name:ACANDA, DIOSNILEY (MA)
Entity type:Individual
Prefix:
First Name:DIOSNILEY
Middle Name:
Last Name:ACANDA
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1490 S MILITARY TRL
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-9190
Mailing Address - Country:US
Mailing Address - Phone:561-324-9459
Mailing Address - Fax:
Practice Address - Street 1:1490 S MILITARY TRL
Practice Address - Street 2:SUITE 6
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-9190
Practice Address - Country:US
Practice Address - Phone:561-324-9459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 57603111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation